Hispanic acculturation and utilization of colorectal cancer screening in the United States

Mona Shah*, Kangmin Zhu, John Potter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Background: Despite the evidence on the effectiveness of colorectal cancer (CRC) screening procedures, its use remains low, especially among Hispanics. Social-cultural factors may play a role in the underutilization of cancer screening. This study aimed to examine whether low acculturation was a risk factor for the underutilization of colorectal cancer screening in the Hispanic population. Methods: The subjects were adults aged 50-80 years who identified themselves as Hispanic and never were diagnosed with colorectal cancer. Colorectal cancer screening utilization was assessed based on the use of at-home Fecal Occult Blood Test (FOBT) and the use of endoscopies (sigmoidoscopy, colonoscopy, or proctoscopy). Respondents who underwent a test for diagnostic purposes were excluded from the study. Results: Our data showed that colorectal screening was underused in Hispanics compared to non-Hispanic Whites. There was a trend that acculturation level was inversely correlated with having an endoscopy in the past 5 years. This trend was also seen with having a FOBT in the past year or an endoscopy in the past 5 years. However, the association disappeared after adjusting for factors pertaining to utilizing other health care services. Additionally, after stratifying by gender, the association between the two variables was diluted. Conclusions: The findings show that low acculturation was associated with the underutilization of endoscopic colorectal cancer screening. This association may be related to lower utilization of health care services and/or language barriers that may contribute to the lower utilization.

Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalCancer Detection and Prevention
Issue number3
StatePublished - 2006
Externally publishedYes


  • Acculturation
  • Colonoscopy
  • Colorectal cancer
  • Cultural barriers
  • Education
  • Endoscopy
  • Family income
  • Fecal occult blood test (FOBT)
  • Hispanics
  • Language barriers
  • Non-Hispanic White
  • Proctoscopy
  • Screening
  • Sigmoidoscopy
  • Sociodemographic variables


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