Abstract B85: Breast and cervical cancer screening among Hispanic and Asian subgroups in the United States: Estimates from the National Health Interview Survey, 2008, 2010 and 2013
Authors: Shoemaker Meredith L. , White Mary C. 
Published: May 2016

Background: In the United States, Hispanic women are less likely to be screened for cervical and breast cancer than non-Hispanic women. Asian women report lower cervical cancer screening use than other races. Previous studies have not differentiated between Hispanic or Asian subgroups or taken into account the heterogeneous nature of these diverse populations. This study aims to better describe variations of mammography and Pap test use across subpopulations of Hispanic and Asian women in the United States.

Methods: Using data from the National Health Interview Survey (2008, 2010, and 2013), we calculated weighted proportions for subgroups of Hispanic and Asian women reporting screening for breast and cervical cancer. We produced cross-tabulations with variables of interest (length of residency, usual source of care, and health insurance), using chi-square tests.

Result: The proportion of Hispanic women age 50-74 years who reported a mammogram within the past 2 years did not differ significantly across subgroups. When stratified by insurance status, proportions of breast cancer screening varied by Hispanic subgroup, among publically insured (p = 0.011) and uninsured (p = 0.001) women. The proportion of women age 21-65 years who received a Pap test within the past 3 years differed significantly across Hispanic subgroups (p = 0.005) as follows: Puerto Rican [82.5%, 95%CI (77.9-86.4)], Mexican [75.6%, 95%CI (73.1-77.9)], Mexican American [81.7%, 95%CI (79.1-84.0)], Cuban/Cuban American [75.1%, 95%CI (68.1-80.9)], Dominican [83.0%, 95%CI (75.8-88.4)], Central or South American [79.9%, 95%CI (76.2-83.1)], and Other Hispanic women [82.7%, 95%CI (74.2-88.8)]. Cervical cancer screening use varied across Hispanic subgroups among recent immigrants (p = 0.002) and publicly insured women (p = 0.041). Among Asian women, the proportion who reported breast cancer screening did not differ significantly by subgroup. For cervical cancer screening, the proportion of Asian women who received a Pap test varied across subgroups (p &lt; 0.001). Filipinas [82.7%, 95%CI (78.0-86.7)] were more likely to be screened for cervical cancer than Asian Indian [66.8%, 95% (60.9-72.2)], Chinese [68.7%, 95%CI (62.5-74.4)], and Other Asian [68.1, 95%CI (63.6-72.2)] women. When stratified for length of residency, Pap test use differed significantly across subgroups of Asian immigrants in the US more than 10 years (p = 0.005) and less than 10 years (p &lt; 0.001). Proportions of cervical cancer screening varied across subgroups of Asian women, among those with a usual source of care (p &lt; 0.001), and with private/military (p = 0.005), public (p &lt; 0.001), or no health insurance (p = 0.006).

Conclusions: Among Hispanic women, mammography use was comparable across subgroups while Pap test use varied. Among Asian women, Pap test use differed by subgroup and mammography use did not. These data suggest certain ethnic and racial subgroups may have different barriers to screening that vary by usual source of care, insurance status, length of residency, and screening type. These findings offer insights that may be valuable for culturally tailored efforts to promote cancer screening within subgroups of Hispanic and Asian women.

Citation Format: Meredith L. Shoemaker, Mary C. White. Breast and cervical cancer screening among Hispanic and Asian subgroups in the United States: Estimates from the National Health Interview Survey, 2008, 2010 and 2013. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B85.