title: Citizenship, length of stay, and screening for breast, cervical, and colorectal cancer in women, 2000-2010.
abstract: BACKGROUND
  Two factors jointly account for significant gaps in access to health care among immigrants who are present in the U.S.-legal status, and length of residence. The objective of this study is to examine the association between citizenship and length of residence in the U.S. and cancer screening (breast, cervical, and colorectal) among women.
  
  
  METHODS
  We analyzed 11 years (2000-2010) of consolidated data from the Medical Expenditure Panel Survey linked with the National Health Interview Survey. Multivariate analyses compared cancer screening among U.S.-born citizens (n = 58,484), immigrant citizens (n = 8,404), and immigrant non-citizens (n = 6,564).
  
  
  RESULTS
  Immigrant non-citizens living in the U.S. for less than 5 years were less likely to receive guideline-concordant breast (OR = 0.68 [0.53-0.88]), cervical (OR = 0.65 [0.54-0.78]), and colorectal (OR = 0.31 [0.19-0.50]) cancer screening compared to U.S.-born citizens. Immigrant citizens and non-citizens living in the U.S. for 5 years or more had higher odds of being screened for breast and cervical cancer compared to U.S.-born citizens; (OR = 1.26 [1.13-1.41] and OR = 1.17 [1.06-1.29]) for immigrant citizens, (OR = 1.28 [1.13-1.45] and OR = 1.23 [1.09-1.38]) for non-citizens. Immigrant non-citizens living in the U.S. for 5 years or more had lower odds of being screened for colorectal cancer compared to U.S.-born citizens (OR = 0.76 [0.65-0.90]).
  
  
  CONCLUSIONS
  Based on these findings, duration mandates in immigration policy may indirectly influence future pathways to preventive health care and cancer disparities disproportionately affecting immigrant women. We suggest that limits of duration mandates be reevaluated, as they may offer pathways to preventive health care for this vulnerable population, and prevent future cancer disparities.
authors.affiliation: Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, 601-D Ford Building, University Park, PA, 16802, USA. pym1@psu.edu.
authors.forename: Patricia Y
authors.initials: PY
authors.lastname: Miranda
authors.affiliation: Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
authors.forename: Nengliang
authors.initials: N
authors.lastname: Yao
authors.affiliation: Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA.
authors.forename: S Amy
authors.initials: SA
authors.lastname: Snipes
authors.affiliation: Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, 601-D Ford Building, University Park, PA, 16802, USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: BeLue
authors.affiliation: Department of Public Health Sciences, Penn State Cancer Institute, College of Medicine, Pennsylvania State University, University Park, PA, USA.
authors.forename: Eugene
authors.initials: E
authors.lastname: Lengerich
authors.affiliation: Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, 601-D Ford Building, University Park, PA, 16802, USA.
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Hillemeier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005260:Female; D006306:Health Surveys; D054625:Healthcare Disparities; D006798:Housing; D006801:Humans; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
keywords: Cancer screening; Immigrants; Women’s health