Compared to Mexican Americans, non-Latino Whites were significantly (P<.01) older, more likely to have a high school diploma, less likely to live below the federal poverty level, more likely to live in a rural area, have a usual source of health care, have health insurance, have seen a doctor within the past year, have good health status, and eat five or more servings of fruits and vegetables per day ().
Descriptive statistics and colorectal cancer screening rates as a function of ethnicity and colorectal cancer test use* from the 2005 California Health Interview Survey among those aged 50 years and older (N=18,304)
CRC Test Use Correlates
Having no CRC test at all (ie, having neither FOBT nor endoscopy) was significantly (P<.05; ) associated with younger age, being Mexican American, not having a high school diploma, living below the federal poverty level, not having a usual source of health care, not having health insurance, not seeing a doctor the previous year, not getting a recommendation from a doctor, having better health status, not eating five or more servings of fruits and vegetables, not being regularly physically active, and being a smoker. Sex and urban status had no association with CRC test use.
Compared to non-Latino Whites, Mexican Americans were more likely to report experiencing more conditions indicative of language barriers (). Nineteen percent of Mexican Americans spoke only English in the home, compared to 90% of non-Latino Whites (P<.01). Forty-five percent of Mexican Americans (compared to <1% of non-Latino Whites) were LEP (spoke no English at home or did not speak it well; P<.01). Significantly more Mexican Americans than non-Latino Whites indicated that they had difficulty understanding the doctor at their last visit (5.5% vs 2.1%, P<.01). Of those who had difficulty understanding their doctor (n=405), more Mexican Americans than non-Latino Whites said it was because the doctor spoke another language (82% vs 48%, P<.01) and more Mexican Americans than non-Latino Whites said they needed someone to help them understand the doctor (67% vs 20%, P<.01). Compared to those having had one or both CRC tests, those without any test, tended not to “speak only English in the home” (68% vs 81%, P<.01), were more likely to be LEP (23% vs 8%, P<.01), had difficulty understanding their doctor due to language (70% vs 55%, P<.05), and needed someone to help them understand their doctor (49% vs 30%; P<.05).
CRC Test Use Rates
Twenty-two percent of non-Latino Whites compared to 43% of Mexican Americans never had a CRC test (P<0.01) (). Forty-three percent of non-Latino Whites compared to 21% of Mexican Americans had previously had both tests (P<.01). Approximately equal proportions of non-Latino Whites and Mexican Americans had ever had either FOBT or endoscopy alone (P>.10). Seventy-eight percent of non-Latino Whites ever had any CRC test; this was significantly more than Mexican Americans (57%; P<.01). Among those who had a CRC test, nearly all reported having the CRC test recently, either FOBT within a year or endoscopy within 10 years.
Colorectal cancer test use rates* as a function of ethnicity and limited English proficiency among those aged 50 years and older from the 2005 California Health Interview Survey (N=18,304)
CRC Test Use Rates by LEP Status
Among Mexican Americans, compared to LEP respondents, non-LEP respondents were significantly more likely to have had FOBT only (10% vs 16%; P=.01), both tests (11% vs 29%; P<.01), and to have ever had any test (45% vs 67%; P<.01) (). Compared to LEP respondents, non-LEP respondents were significantly less likely to have had neither test (55% vs 33%, P<.01).
The logistic regression model was well-specified. Correlations between all variables included in the logistic regression model indicated that the variables were not collinearly related nor were large confidence intervals observed around odds ratio estimates.
reports the logistic regression to predict never having either CRC test. Non-Latino Whites, those who were older, had higher education, had lower poverty status, had a usual source of health care, had health insurance, saw a doctor in the past year, were physically active on a regular basis, and were a smoker were less likely to have had neither FOBT nor endoscopy (P<.05).
Logistic regression model to predict never receiving any colorectal cancer test use from the 2005 California Health Interview Survey among Mexican Americans and non-Latino White adults aged 50 years and older (N=18,304)
After adjustment for covariates, Mexican Americans were 1.32 times as likely as non-Latino Whites to have either CRC test (P=.01). Those with limited English proficiency were 1.68 times more likely as those without to have never had any CRC test (P<0.01).
Reported Reasons for Not Getting a CRC Test
Many Mexican Americans and non-Latino Whites said they did not have an endoscopy because they “put it off” (18% and 20%, respectively) or because it was “painful, embarrassing, or unpleasant” (14% and 23%, respectively) (); significantly more non-Latino Whites indicated the latter compared to Mexican Americans (P=.01). Compared to non-Latino Whites, Mexican Americans more often cited provider barriers (“test was not recommended” and “did not know the test was needed”) as the reason for not obtaining an endoscopy (P<0.10). Non-Latino Whites more often said they did not get an endoscopy for “no reason” or because they “never thought of it” (P<0.10). Mexican Americans were more likely to report any provider barrier whereas non-Latino Whites were more likely to report any patient barrier (P<0.05).
Percent stating reasons for not having a CRC test by ethnicity from the 2005 California Health Interview Survey among those aged 50 years and older
The two most common reasons that both Mexican Americans and non-Latino Whites gave for not having the FOBT was due to patient barriers—they either “put off” having the FOBT or thought it was “too painful, embarrassing, or unpleasant.” Mexican Americans more often reported that the reason for not having an FOBT was because they “did not have a doctor” (P=.03). Non-Latino Whites more often said they did not get an FOBT because they “have not had any problems” (P=.05).