ASPO Abstracts
Understanding the Role of Access in Hispanic Cancer Screening Disparities
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Background. Hispanic populations in the US experience numerous barriers to care access. It is unclear how access differences are associated with disparities in cancer screening use. Objective. Understand the extent to which cancer screening disparities between Hispanic and non-Hispanic White individuals are explained by access to care – including having a usual source of care and health insurance coverage. Methods. We conducted a secondary analysis of the 2019 National Health Interview Survey, including respondents who were sex- and age-eligible for cervical (n=8,316), breast (n=6,025), or colorectal cancer screening (n=11,313). We compared proportion ever screened and up to date for each screening type. We performed serial regression to examine whether controlling for reporting a usual source of care and type of health insurance (public, private, none) attenuated disparities between Hispanics and non-Hispanic White individuals. Results. Hispanic individuals were less likely than non-Hispanic White individuals to be up to date with cervical cancer screening (71.6% vs. 74.6%) and colorectal cancer screening (52.9% vs. 70.3%), but up-to-date screening was similar for breast cancer (78.8% vs 76.3%). Hispanic individuals (vs. Non-Hispanic White) were less likely to have a usual source of care (77.9% vs. 86.0%) and more likely to be uninsured (23.6% vs. 7.1%). In regressions, insurance fully attenuated cervical cancer disparities. Controlling for both usual source of care and insurance type explained around half of the colorectal cancer screening disparities (adjusted risk difference: -8.3 [-11.2,-4.8]). Conclusion. Addressing the high rate of uninsurance among Hispanic individuals could mitigate cancer screening disparities. Future research should build on the relative successes of breast cancer screening and investigate additional barriers present in colorectal cancer screening.
Keywords: screening, cervical, colorectal, breast, equity