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Language a Barrier to Colorectal Cancer Screening in Mexican-Americans

 Newswise — More than 40 percent of Mexican-Americans in California have never had either of the most common screening tests for colorectal cancer, compared with 22 percent of non-Latino white Californians, which could be due to language barriers between patients and physicians, suggests a new study from San Diego State University.

Nationally, Latinos are more likely to receive a diagnosis of colorectal cancer in advanced stages and have a lower survival rate than non-Latino whites.

In the study of nearly 17,000 California residents ages 50 and older, a greater percentage of those of Mexican descent said they had problems with language when dealing with health providers. About 30 percent of Californians are of Mexican descent or birth.

The findings, which appear in the summer issue of the journalEthnicity & Disease, is based on information collected in the 2005 California Health Interview Survey, a telephone survey.

About three times as many Mexican-Americans as non-Latino whites said they had never had an endoscopy or a fecal occult blood test, the most common screening methods for colorectal cancer, because they did not know they needed to be screened. Sixty-seven percent of Mexican-Americans said they needed someone to help them understand the doctor, compared with 20 percent of non-Latino whites.

However, the study might overstate the importance of language problems as a barrier to screening for colorectal cancer, according to an expert who had no affiliation with the study.

The disparity in screening levels might also be due to cultural issues not unique to Hispanics, said Luisa Borrell, an associate professor with the graduate program in public health at Lehman College, City University of New York.

It might have been better to make a comparison to Asian-Americans, said Borrell, citing lopsided proportions from a 2002 ethnic breakdown of California physicians. Although Hispanics make up roughly a third of the state’s population, only 4 percent of physicians are Hispanic. Yet, Asian-Americans, who make up 12 percent of the population, represent 22 percent of the state’s physicians.

“The pipeline for Hispanics to increase the number of physicians is not ready to match the demand of the fast-growing Hispanic population now or in the near future,” she said.

California was one of the first states to pass a law requiring a translator in health care settings, Borrell said. “The appropriate use of medical translators in California could alleviate the language barrier not only for Hispanics, but also other minority groups.”


Ethnicity & Disease is a quarterly medical journal studying the ethnic patterns of disease. For more information, or visit

Johnson-Kozlow M, et al. Colorectal cancer test use among Californians of Mexican origin: influence of language barriers.Ethnicity & Disease 19(3), 2009.

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