title: Cancer screening among Native Americans in California.
abstract: OBJECTIVE
  To determine the factors associated with cancer screening adherence among Native Americans living in California.
  
  
  METHODS
  2,266 Native Americans identified from the California Health Interview Surveys during 2001, 2003, and 2005 eligible for cervical, breast, or colorectal cancer screening.
  
  
  METHODS
  We fit multivariable logistic regression models to identify demographic and healthcare access predictors of adherence to cancer screening.
  
  
  RESULTS
  The presence of a recent physician visit was significantly associated with cervical (odds ratio [OR] 7.34, 95% confidence interval [CI] 4.27, 12.6), breast (OR 3.29, 95% CI 2.0, 5.42), and colorectal (OR 3.02, 95% Cl 1.74, 5.23) cancer screening adherence. The report of a usual source of care was similarly positively associated with cervical, breast, and colorectal cancer screening adherence. Additional predictors for colorectal cancer screening included higher educational attainment (OR 1.56, 95% Cl 1.07, 2.28), and the presence of a comorbid condition (OR 1.54, 95% CI 1.16, 2.05). Experiencing discrimination (OR .42, 95% Cl .20, .89) and never being married (OR .49, 95% CI .27, .89) were negative predictors of breast cancer screening, while having insurance (OR 2.00, 95% CI 1.27, 3.15) was a positive predictor. Cervical cancer screening was positively associated with living at or above 300% of the federal poverty level (OR 2.69, 95% CI 1.50, 4.85).
  
  
  CONCLUSIONS
  Regular access to health care and a physician are the most consistent predictors of cancer screening adherence among Native Americans and should represent a focus of activities to improve screening rates in these communities.
authors: Department of Family and Community MedicineUniversity of New Mexico, Albuquerque, NM 87131-0001, USA. VSimonds@salud.unm.edu
authors: Vanessa W
authors: VW
authors: Simonds
authors: Graham A
authors: GA
authors: Colditz
authors: Rima E
authors: RE
authors: Rudd
authors: Thomas D
authors: TD
authors: Sequist
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D002140:California; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012959:Socioeconomic Factors; D055815:Young Adult