title: Colorectal cancer test use among Californians of Mexican origin: influence of language barriers.
abstract: OBJECTIVE
  Striking decreases in colorectal cancer (CRC) incidence have been seen recently in non-Latino Whites but not in Latinos. The purpose of our study was to examine the influence of limited English proficiency (LEP) on differences in CRC test use rates between Mexican American and non-Latino White adults in California and reported reasons for not getting a CRC exam.
  
  
  METHODS
  Cross-sectional analysis of the 2005 California Health Interview Survey (CHIS).
  
  
  METHODS
  Representative sample of non-institutionalized adults living in California.
  
  
  METHODS
  Mexican American (n = 1,529) and non-Latino White men and women aged 50 and older (n = 16,775) who had not been diagnosed with CRC.
  
  
  METHODS
  Logistic regression analyzed the effect of ethnicity and limited English proficiency (LEP) on CRC test use after adjusting for sociodemographics, healthcare access, health status, and other health behaviors.
  
  
  METHODS
  Respondents' likelihood of not receiving the CRC exam was examined as a function of ethnicity and LEP status; differences in reasons for not receivingCRC testing between ethnic groups were also examined.
  
  
  RESULTS
  More than 40% of Californian Mexican American adults aged 50 and older have never had either fecal occult blood test or lower endoscopy CRC tests. Mexican Americans were more likely to have difficulty understanding their doctor due to language barriers (P < .01). Mexican Americans more often reported provider barriers in getting an endoscopy (ie, test was not recommended by their medical provider) than non-Latino Whites (P = .01). After adjustment for covariates, Mexican Americans were 1.32 times and those with LEP were 1.68 times more likely to have never had either CRC test.
  
  
  CONCLUSIONS
  Limited English proficiency significantly decreased the likelihood of getting tested for CRC (P < .01). Eliminating language barriers should result in improvements in CRC test use among limited English proficiency Mexican Americans.
authors.affiliation: School of Public Health, San Diego State University, San Diego, California, USA. mfjohnson@projects.sdsu.edu
authors.forename: Marilyn
authors.initials: M
authors.lastname: Johnson-Kozlow
authors.forename: Stergios
authors.initials: S
authors.lastname: Roussos
authors.forename: Liza
authors.initials: L
authors.lastname: Rovniak
authors.forename: Melbourne
authors.initials: M
authors.lastname: Hovell
mesh_terms: D000368:Aged; D002140:California / Q000453:epidemiology; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000517:prevention & control*; D003144:Communication Barriers; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007802:Language; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D010817:Physician-Patient Relations; D044465:White People / Q000706:statistics & numerical data