Journal of General Internal Medicine
Volume 20, Issue 3, 2005, Pages 290-296

Impact of U.S. citizenship status on cancer screening among immigrant women (Review)

De Alba I.* , Hubbell F.A. , McMullin J.M. , Sweningson J.M. , Saitz R.
  • a Div. Gen. Int. Med. and Prim. Care, Department of Medicine, University of California, Irvine, CA, United States, Ctr. for Health Policy and Research, Irvine, CA, United States, 111 Academy Way, Irvine, CA 92697-5800, United States
  • b Div. Gen. Int. Med. and Prim. Care, Department of Medicine, University of California, Irvine, CA, United States, Ctr. for Health Policy and Research, Irvine, CA, United States
  • c Div. Gen. Int. Med. and Prim. Care, Department of Medicine, University of California, Irvine, CA, United States, Ctr. for Health Policy and Research, Irvine, CA, United States, Department of Anthropology, School of Social Ecology, University of California, Irvine, CA, United States
  • d Ctr. for Health Policy and Research, Irvine, CA, United States
  • e Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA, United States, Department of Epidemiology, Boston Univ. School of Public Health, Boston, MA, United States

Abstract

OBJECTIVES: We evaluated the relationship between U.S. citizenship status and the receipt of Pap smears and mammograms among immigrant women in California. DESIGN: Cross-sectional study using data from the 2001 California Health Interview Survey. PATIENTS/PARTICIPANTS: Noninstitutionalized, civilian women, aged 18 years and older living in California. MEASUREMENTS AND MAIN RESULTS: We analyzed data from the 2001 California Health Interview Survey and used logistic regression models to adjust for sociodemographic factors and for access and utilization of health services. After adjusting we found that U.S. citizen immigrants were significantly more likely to report receiving a Pap smear ever (adjusted prevalence ratio [aPR], 1.05; 95% confidence interval [CI], 1.01 to 1.08), a recent Pap smear (aPR, 1.07; 95% CI, 1.03 to 1.11), a mammogram ever (aPR, 1.17; 95% CI, 1.12 to 1.21), and a recent mammogram (aPR, 1.38; 95% CI, 1.26 to 1.49) as compared to immigrants who are not U.S. citizens. Also associated with receiving cancer screening were income, having a usual source of care, and having health insurance. Hispanic women were more likely to receive Pap smears as compared to whites and Asians. CONCLUSIONS: Not being a U.S. citizen is a barrier to receiving cervical and breast cancer screening. Additional research is needed to explore causal factors for differences in cancer screening rates between citizens and noncitizens.

Author Keywords

Pap smear citizenship Women Mammogram Immigrant

Index Keywords

Vaginal Smears immigrant educational status breast cancer Asian Confounding Factors (Epidemiology) logistic regression analysis health insurance human middle aged Odds Ratio Ethnic Groups controlled study health status Aged cancer screening Logistic Models Insurance, Health Hispanic Americans Cross-Sectional Studies interview United States income social status Humans Mammography Asian Americans female Socioeconomic Factors Multivariate Analysis Review health care utilization adult uterine cervix cancer Papanicolaou Test Emigration and Immigration African Americans Health Services Accessibility health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-18244370769&doi=10.1111%2fj.1525-1497.2005.40158.x&partnerID=40&md5=6ae5fb11a35790b3732894a831a6e871
DOI: 10.1111/j.1525-1497.2005.40158.x
ISSN: 08848734
Cited by: 93
Original Language: English