Effect of language on colorectal cancer screening among Latinos and non-Latinos.
BACKGROUND
Language barriers among some Latinos may contribute to the lower rates of colorectal cancer (CRC) screening between Latinos and non-Latino Whites. The purpose of this study was to examine the relationship between language and receipt of CRC screening tests among Latinos and non-Latinos using a geographically diverse, population-based sample of adults.


METHODS
Cross-sectional analysis of the Behavioral Risk Factor Surveillance System (BRFSS) survey. Analysis included adults age 50 years and older, who completed the 2006 BRFSS in a state that recorded data from English- and Spanish-speaking participants.


RESULTS
The primary outcome measure was receipt of colorectal screening tests (fecal occult blood testing within prior 12 months and/or lower endoscopy within 10 years). Of the 99,895 respondents included in the study populations, 33% of Latinos responding-in-Spanish reported having had CRC testing, whereas 51% of Latinos responding-in-English and 62% of English-speaking non-Latinos reported test receipt. In multivariable analysis, compared with non-Latinos, Latinos responding-in-English were 16% less likely to have received CRC testing [odds ratio (OR), 0.84; 95% confidence interval (95% CI), 0.73-0.98], and Latinos responding-in-Spanish were 43% less likely to have received CRC testing (OR, 0.57; 95% CI, 0.44-0.74). Additionally, compared with Latinos responding-in-English, Latinos responding-in-Spanish were 36% less likely to have received CRC testing (OR, 0.64; 95% CI, 0.48-0.84).


CONCLUSIONS
Latinos responding to the 2006 BRFSS survey in Spanish had a significantly lower likelihood of receiving CRC screening tests compared with non-Latinos and to Latinos responding-in-English. Based on this analysis, Spanish language use is negatively associated with CRC screening and may contribute to disparities in CRC screening.
Diaz
Joseph A
JA
Center for Primary Care and Prevention, Memorial Hospital of RI, 111 Brewster Street, Pawtucket, RI 02860, USA. Joseph_Diaz@Brown.edu
Roberts
Mary B
MB
Goldman
Roberta E
RE
Weitzen
Sherrie
S
Eaton
Charles B
CB
D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology