Citizenship, length of stay, and screening for breast, cervical, and colorectal cancer in women, 2000-2010
Citizenship, length of stay, and screening for breast, cervical, and colorectal cancer in women, 2000-2010
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DOI：
10.1007/s10552-017-0887-x
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发表时间：
2017-06-01
影响因子：
2.3
通讯作者：
Hillemeier, Marianne M.
中科院分区：
文献类型：
--
作者：
Miranda, Patricia Y.;Yao, Nengliang;Hillemeier, Marianne M.
背景两个因素共同解释了在美国的移民在获得医疗保健方面的显著差距--法律地位和居留时间。这项研究的目的是检验公民身份和在美国居住的时间与女性癌症筛查(乳腺癌、宫颈癌和结直肠癌)之间的关系。方法我们分析了11年来(2000-2010年)医疗支出小组调查与国家健康访谈调查相结合的综合数据。多因素分析比较了在美国出生的公民(n=58,484)、移民公民(n=8,404)和移民非公民(n=6,564)的癌症筛查。结果与美国出生的公民相比，居住在美国小于5年的移民非公民接受符合指南的乳房(OR=0.68[0.53-0.88])、宫颈癌(OR=0.65[0.54-0.78])和结直肠癌(OR=0.31[0.19-0.50])癌症筛查的可能性较低。与在美国出生的公民相比，移民公民和在美国居住5年或以上的非公民接受乳腺癌和宫颈癌筛查的几率更高；移民公民(OR=1.26[1.13-1.41]和OR=1.17[1.06-1.29])，非公民(OR=1.28[1.13-1.45]和OR=1.23[1.09-1.38])。与在美国出生的公民相比，在美国居住5年或更长时间的非公民移民接受结直肠癌筛查的几率较低(OR=0.76[0.65-0.90])。结论基于这些发现，移民政策中的期限规定可能间接影响未来预防保健的途径，并且癌症差异对移民女性的影响不成比例。我们建议重新评估期限规定，因为它们可能为这一弱势群体提供预防性保健的途径，并防止未来的癌症差异。
Background Two factors jointly account for significant gaps in access to health care among immigrants who are present in the U.S.-legal status, and length of residence. The objective of this study is to examine the association between citizenship and length of residence in the U.S. and cancer screening (breast, cervical, and colorectal) among women.Methods We analyzed 11 years (2000-2010) of consolidated data from the Medical Expenditure Panel Survey linked with the National Health Interview Survey. Multivariate analyses compared cancer screening among U.S.-born citizens (n = 58,484), immigrant citizens (n = 8,404), and immigrant non-citizens (n = 6,564).Results Immigrant non-citizens living in the U.S. for less than 5 years were less likely to receive guideline-concordant breast (OR = 0.68 [0.53-0.88]), cervical (OR = 0.65 [0.54-0.78]), and colorectal (OR = 0.31 [0.19-0.50]) cancer screening compared to U.S.-born citizens. Immigrant citizens and non-citizens living in the U.S. for 5 years or more had higher odds of being screened for breast and cervical cancer compared to U.S.-born citizens; (OR = 1.26 [1.13-1.41] and OR = 1.17 [1.06-1.29]) for immigrant citizens, (OR = 1.28 [1.13-1.45] and OR = 1.23 [1.09-1.38]) for non-citizens. Immigrant non-citizens living in the U.S. for 5 years or more had lower odds of being screened for colorectal cancer compared to U.S.-born citizens (OR = 0.76 [0.65-0.90]).Conclusions Based on these findings, duration mandates in immigration policy may indirectly influence future pathways to preventive health care and cancer disparities disproportionately affecting immigrant women. We suggest that limits of duration mandates be reevaluated, as they may offer pathways to preventive health care for this vulnerable population, and prevent future cancer disparities.