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Effect of Language on Colorectal Cancer Screening Among Latinos and Non-Latinos

¹ Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island; ² Division of General Internal Medicine, Departments of ³ Family Medicine, and ⁴ Community Health, The Warren Alpert Medical School of Brown University, Providence, Rhode Island

Requests for reprints: Joseph A. Diaz, Center for Primary Care and Prevention, Memorial Hospital of RI, 111 Brewster Street, Pawtucket, RI 02860. Phone: 401-729-3400. Fax: 401-729-2494; E-mail: Joseph_Diaz{at}Brown.edu

Background: Language barriers among some Latinos may contribute to the lower rates of colorectal cancer (CRC) screening between Latinos and non-Latino Whites. The purpose of this study was to examine the relationship between language and receipt of CRC screening tests among Latinos and non-Latinos using a geographically diverse, population-based sample of adults.

Methods: Cross-sectional analysis of the Behavioral Risk Factor Surveillance System (BRFSS) survey. Analysis included adults age 50 years and older, who completed the 2006 BRFSS in a state that recorded data from English- and Spanish-speaking participants.

Results: The primary outcome measure was receipt of colorectal screening tests (fecal occult blood testing within prior 12 months and/or lower endoscopy within 10 years). Of the 99,895 respondents included in the study populations, 33% of Latinos responding-in-Spanish reported having had CRC testing, whereas 51% of Latinos responding-in-English and 62% of English-speaking non-Latinos reported test receipt. In multivariable analysis, compared with non-Latinos, Latinos responding-in-English were 16% less likely to have received CRC testing [odds ratio (OR), 0.84; 95% confidence interval (95% CI), 0.73-0.98], and Latinos responding-in-Spanish were 43% less likely to have received CRC testing (OR, 0.57; 95% CI, 0.44-0.74). Additionally, compared with Latinos responding-in-English, Latinos responding-in-Spanish were 36% less likely to have received CRC testing (OR, 0.64; 95% CI, 0.48-0.84).

Conclusion: Latinos responding to the 2006 BRFSS survey in Spanish had a significantly lower likelihood of receiving CRC screening tests compared with non-Latinos and to Latinos responding-in-English. Based on this analysis, Spanish language use is negatively associated with CRC screening and may contribute to disparities in CRC screening. (Cancer Epidemiol Biomarkers Prev 2008;17(8):2169–73)