The Relationship between Neighborhood Immigrant Composition, Limited English Proficiency, and Late-Stage Colorectal Cancer Diagnosis in California.
Despite the availability of effective early detection technologies, more than half (61%) of colorectal cancers in the United States and 55% in California are identified at an advanced stage. Data on colorectal cancer patients (N = 35,030) diagnosed from 2005 to 2007 were obtained from the California Cancer Registry. Multivariate analyses found a relationship among neighborhood concentration of recent immigrants, neighborhood rates of limited English proficiency, and late-stage colorectal cancer diagnosis. Hispanics living in neighborhoods with a greater percentage of recent immigrants (compared to the lowest percentage) had greater odds (OR 1.57, 95% CI 1.22, 2.02) of late-stage diagnosis whereas Hispanics living in neighborhoods with the highest percentage of limited English proficiency (compared to the lowest percentage) had lower odds (OR .71, 95% CI .51, .99) of late-stage diagnosis. These relationships were not observed for other ethnic groups. Results highlight the complex relationship among race/ethnicity, neighborhood characteristics, and colorectal cancer stage at diagnosis.
Department of Epidemiology and Biostatistics, Cancer Therapy & Research Center, School of Medicine, Institute for Health Promotion Research, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1000, San Antonio, TX 78229, USA.
Cynthia M
CM
Mojica
Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, Kaiser Permanente Center for Health Equity, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095-6900, USA.
Beth A
BA
Glenn
Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095-6900, USA.
Cindy
C
Chang
Center for Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, Kaiser Permanente Center for Health Equity, Fielding School of Public Health, University of California, Los Angeles, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA 90095-6900, USA.
Roshan
R
Bastani
D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D042241:Early Diagnosis; D054242:Emigrants and Immigrants; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007182:Income; D007348:Insurance, Health; D007802:Language; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012042:Registries; D012111:Residence Characteristics