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Medical Care:
November 2006 - Volume 44 - Issue 11 - pp 998-1004
doi: 10.1097/01.mlr.0000233676.61237.ef
Original Article

Is there a Language Divide in Pap Test Use?

Ponce, Ninez A. PhD, MPP; Chawla, Neetu MPH; Babey, Susan H. PhD; Gatchell, Melissa S. MPH; Etzioni, David A. MD, MSHS; Spencer, Benjamin A. MD, MPH; Brown, E Richard PhD; Breen, Nancy PhD

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Abstract

Objective: We sought to determine whether primary language use, measured by language of interview, is associated with disparities in cervical cancer screening.

Data sources: We undertook a secondary data analysis of a pooled sample of the 2001 and 2003 California Health Interview Surveys. The surveys were conducted in English, Spanish, Cantonese, Mandarin, Korean, and Vietnamese.

Study Design: The study was a cross-sectional analysis of 3-year Pap test use among women ages 18 to 64, with no reported cervical cancer diagnosis or hysterectomy (n = 38,931). In addition to language of interview, other factors studied included race/ethnicity, marital status, income, educational attainment, years lived in the United States, insurance status, usual source of care, smoking status, area of residence, and self-rated health status.

Data Collection/Extraction Methods: We fit weighted multivariate logit models predicting 3-year Pap test use as a function of language of interview, adjusting for the effects of specified covariates.

Principal Findings: Compared with the referent English interview group, women who interviewed in Spanish were 1.65 times more likely to receive a Pap test in the past 3 years. In contrast, we observed a significantly reduced risk of screening among women who interviewed in Vietnamese (odds ratio [OR] 0.67; confidence interval [CI] 0.48-0.93), Cantonese (OR 0.44; 95% CI 0.30-0.66), Mandarin (OR 0.48; 95% CI 0.33-0.72), and Korean (OR 0.62; 0.40-0.98).

Conclusions: Improved language access could reduce cancer screening disparities, especially in the Asian immigrant community.

© 2006 Lippincott Williams & Wilkins, Inc.

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