Perceived discrimination and cancer screening behaviors in US  Hispanics: the Hispanic Community Health Study/Study  of Latinos Sociocultural Ancillary Study.
OBJECTIVE
Perceived discrimination has been associated with lower adherence to cancer screening guidelines. We examined whether perceived discrimination was associated with adherence to breast, cervical, colorectal, and prostate cancer screening guidelines in US Hispanic/Latino adults.


METHODS
Data were obtained from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study, including 5,313 Hispanic adults aged 18–74 from Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA, and those who were within appropriate age ranges for specific screening tests were included in the analysis. Cancer screening behaviors were assessed via self-report. Perceived discrimination was measured using the Perceived Ethnic Discrimination Questionnaire. Confounder-adjusted multivariable polytomous logistic regression models assessed the association between perceived discrimination and adherence to cancer screening guidelines.


RESULTS
Among women eligible for screening, 72.1 % were adherent to cervical cancer screening guidelines and 71.3 %were adherent to breast cancer screening guidelines. In participants aged 50–74, 24.6 % of women and 27.0 % of men were adherent to fecal occult blood test guidelines; 43.5 % of women and 34.8 % of men were adherent to colonoscopy/sigmoidoscopy guidelines; 41.0 % of men were adherent to prostate-specific antigen screening guidelines. Health insurance coverage, rather than perceived ethnic discrimination,was the variable most associated with receiving breast, cervical,colorectal, or prostate cancer screening.


CONCLUSIONS
The influence of discrimination as a barrier to cancer screening may be modest among Hispanics/Latinos in urban US regions. Having health insurance facilitates cancer screening in this population. Efforts to increase cancer screening in Hispanics/Latinos should focus on increasing access to these services, especially among the uninsured.
Cristina
C
Valdovinos
Frank J
FJ
Penedo
Carmen R
CR
Isasi
Molly
M
Jung
Robert C
RC
Kaplan
Rebeca Espinoza
RE
Giacinto
Patricia
P
Gonzalez
Vanessa L
VL
Malcarne
Krista
K
Perreira
Hugo
H
Salgado
Melissa A
MA
Simon
Lisa M
LM
Wruck
Heather A
HA
Greenlee
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D002641:Chicago; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D003113:Colonoscopy; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D010465:Perception; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D063505:Racism / Q000208:ethnology* / Q000523:psychology; D012812:Sigmoidoscopy; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology