151406 Health Disparities in Cancer Screening among US Women Workers

Tuesday, November 6, 2007

Lora E. Fleming, MD, PhD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - OHH Center and NIOSH Research Group, Miami, FL
David Lee, PhD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Sharon L. Christ, PhD , Purdue University, University of North Carolina at Chapel Hill, West Lafayette, IN
Kathryn E. McCollister, PhD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Kristopher L. Arheart, EdD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
William G. LeBlanc, PhD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Alberto J. Caban-Martinez, MPH , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Katherine Chung-Bridges, MD, MPH , Family Medicine and Community Health, University of Miami Miller School of Medicine, Miami, FL
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.

Learning Objectives:
1. Identify the apparent health disparities in the reported cancer screening behaviors of Hispanic vs Non Hispanic US women workers 2. Explore possible sustainable solutions to this disparity 3. Identify the National Health Interview Survey as an important source of cancer behavior and health disparity information for the entire US population

Keywords: Occupational Health, Women's Health

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.