Health Disparities in Cancer Screening among US Women Workers

Purpose: The objective of this study was to assess variability in colorectal, breast and cervical cancer screening in a nationally representative sample of US women workers to identify groups which should be targeted for cancer screening interventions.

Methods: Employed National Health Interview Survey (NHIS) participants > 50 years (representing an estimated 6,984,767 US women workers) were asked if they had ever had a colorectal exam (i.e. a sigmoidoscopy, colonoscopy, or proctoscopy), women > 40 years if they had ever had a mammogram (estimated 14,920,874), and women > 18 years (estimated 30,043,045) if they had ever had a pap smear. Prevalence rates were adjusted for the survey design.

Results: Compared to non-Hispanics, Hispanic women workers were less likely to report ever having a pap smear (95% vs. 85%; p<0.05), a mammogram (87% vs. 78%; p<0.05) and a colorectal exam (31% vs 23%; p<0.05). The ethnicity gap in screening for both cancers was least pronounced for white collar workers, and most pronounced for blue-collar and service workers. For these latter two worker groups, Hispanic women workers reported screening rates which were 7-15 percentage points lower than their non-Hispanic counterparts. Conclusions: Hispanic blue collar and service women workers reported markedly lower lifetime use of pap smear, mammography and colorectal screening relative to non-Hispanic women workers in these important sectors of the US workforce. Effective worksite-based cancer screening programs targeting all women workers, and Hispanic women workers in particular, are urgently needed.