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Cancer screening among Native Americans in California
Vanessa W Simonds1, Graham A Colditz, Rima E Rudd
1Department of Family and Community MedicineUniversity of New Mexico, Albuquerque, NM 87131-0001, USA. VSimonds@salud.unm.edu
Objective:
To determine the factors associated with cancer screening adherence among Native Americans living in California.
Participants:
2,266 Native Americans identified from the California Health Interview Surveys during 2001, 2003, and 2005 eligible for cervical, breast, or colorectal cancer screening.
Methods:
We fit multivariable logistic regression models to identify demographic and healthcare access predictors of adherence to cancer screening.
Results:
The presence of a recent physician visit was significantly associated with cervical (odds ratio [OR] 7.34, 95% confidence interval [CI] 4.27, 12.6), breast (OR 3.29, 95% CI 2.0, 5.42), and colorectal (OR 3.02, 95% Cl 1.74, 5.23) cancer screening adherence. The report of a usual source of care was similarly positively associated with cervical, breast, and colorectal cancer screening adherence. Additional predictors for colorectal cancer screening included higher educational attainment (OR 1.56, 95% Cl 1.07, 2.28), and the presence of a comorbid condition (OR 1.54, 95% CI 1.16, 2.05). Experiencing discrimination (OR .42, 95% Cl .20, .89) and never being married (OR .49, 95% CI .27, .89) were negative predictors of breast cancer screening, while having insurance (OR 2.00, 95% CI 1.27, 3.15) was a positive predictor. Cervical cancer screening was positively associated with living at or above 300% of the federal poverty level (OR 2.69, 95% CI 1.50, 4.85).
Conclusions:
Regular access to health care and a physician are the most consistent predictors of cancer screening adherence among Native Americans and should represent a focus of activities to improve screening rates in these communities.
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