Cancer screening disparities: Latina patients' culturally determined contributions to diagnostic delays in breast cancer screening

Despite the benefits of early detection and treatment of all cancers, the elimination of disparities in breast cancer mortality rates among specific racial/ethnic groups remains a social justice issue and a national public health priority. Given that breast cancer is the leading cause of cancer deaths among Latina women (U.S. Cancer Statistics Working Group, 2009), cultural and linguistic relevance must be an important component of public health practice. This paper compares Latina and Caucasian women's contributions to diagnostic delays and integrates international literature on cross cultural communication. We conducted a secondary analysis of data based on initial research that utilized data from the 1997 University of California at San Francisco Institute for Health and Aging Breast Cancer Screening Evaluation Project Time-to-Diagnosis Survey. The initial research analyzed a sub-set of 225 Latina and 107 Caucasian women with abnormal mammography who were within 200 percent of the federal poverty guidelines. Constructs from the international cross-cultural communication literature were used to explain how the constructs of collectivism, uncertainty avoidance, time orientation, and power distance explain differences between Caucasian and Latina participants. Using self-reported time to make a decision after being told that diagnostic tests were needed as the dependent variable, logistic regression in the initial analysis, indicated that Caucasian women were 1.68 times more likely to decide what to do in less than a day than were Latina women. This analysis focused on the role of cross-cultural communication between patients and providers as a factor influencing Latinas' breast cancer screening.