Lubetkin 2008


Year: 2008

Title: Predictors of cancer screening among low-income primary care patients

Country: United States

Age: Adult Only

Sex: Female

Population: Multiple Groups

Care Setting: Outpatient Ambulatory and Primary Care

Clinical Setting: Breast Cancer Screening

Data Level: Multi-Institution

Data Type: EHR

Data Source: Local data

Conclusion: Disparities In Some Minority Groups

Health OutComes Reported: No

Mitigation: Yes

Free Text Conclusion: Chinese-American less likely than Hispanic or Black patients to get mammography. Mitigated by physician recommendation.

Abstract: Although population-based studies report lower rates of cancer screening among racial/ethnic minorities than among Whites in the U.S., few studies have examined predictors of screening among low-income Hispanic, Black, and Chinese primary care patients. We examined utilization of mammography, Pap smear, digital rectal examination, fecal occult blood testing, sigmoidoscopy/ colonoscopy, and prostate-specific antigen testing in 833 patients from 2 community health centers in New York City, ascertaining relationships between use of screening and race/ethnicity, income, education, years in the U.S., insurance, cancer risk perception, family disease history, and physician recommendation. Despite similar access to primary care, Hispanics and Blacks reported higher utilization rates of all screening tests than Chinese (p<.01). Physician recommendation and more years in the U.S. were associated with greater use of all screening services (p<.001), with physician recommendation most strongly associated with screening. Interventions to enhance screening by at-risk groups should emphasize both physician recommendation and culturally-sensitive patient education.