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Erica Ilene Lubetkin, MD, MPH1, Annabel Santana, MPH1, and Haomiao Jia, PhD2. (1) Department of Community Health and Social Medicine, CUNY Medical School/Sophie Davis School of Biomedical Education, 138th Street and Convent Avenue, New York, NY 10031, (212) 650-7785, lubetkin@scisun.sci.ccny.cuny.edu, (2) Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA 31207
BACKGROUND: Few studies have explored differences in cancer screening rates among persons of different racial/ethnic groups and low socioeconomic status (SES) who have a usual source of care. This study examined self-reported use of screening services and perceptions of cancer risk among low-income racial/ethnic primary care patients in NYC. METHODS: 833 Hispanic, Black and Chinese adult patients enrolled in two Community Health Centers were surveyed in 2002. Utilization of mammography, Pap smear, digital rectal examination, prostate-specific antigen testing, fecal occult blood testing, and sigmoidoscopy/colonoscopy was assessed. Relationships between use of these services and patients’ cancer risk perceptions by race/ethnicity, and the impact of income, education, years in the U.S., insurance status, family disease history, and physician recommendation were ascertained. RESULTS: Racial/ethnic differences in screening utilization were noted (p-value < 0.01), with Black and Hispanic patients reporting higher rates of utilization of all screening tests than Chinese patients. Physician recommendation and more years in the U.S. were associated with use of all screening services (p <0.001), while neither education nor income were significant factors associated with screening utilization. After adjusting for age and insurance, racial/ethnic differences persisted. Physician recommendation showed the strongest association with screening use. Patients who perceived themselves at “much lower” risk of developing disease compared to others were less likely to report mammography and Pap smear use. CONCLUSIONS: Interventions to enhance screening utilization by at-risk groups should emphasize both physician recommendation and culturally-sensitive patient education. Cultural factors which may adversely impact screening behavior should be further explored.
Learning Objectives:
Keywords: Ethnic Minorities, Cancer Screening
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.