A Population Based Study Examining Language as a Predictor of Colorectal Cancer Screening Among Overweight and Obese Hispanic Adults in the United States

William S. Pearson*, 1, Shanta R. Dube2, Laura C. Seeff3, Earl S. Ford1, Ali H. Mokdad4, Michael F. Dulin5
1 Behavioral Surveillance Branch, Division of Adult and Community Health, Centers for Disease Control andPrevention, Atlanta, GA, USA
2 Epidemiology Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
3 Office of Colorectal Cancer Programs, Division of Cancer Prevention and Control, Centers for Disease Control andPrevention, Atlanta, GA, USA
4 Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
5 Department of Family Medicine, Carolinas Medical Center, Charlotte, NC, USA

© 2009Pearson et al..

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Division of Adult and Community Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE MS K-66, Atlanta, GA 30326, USA; Tel: 770-488- 5429; E-mail:



Colorectal cancer (CRC) is one of the top two leading causes of cancer deaths in Hispanic/Latino adults living in the U.S., and CRC risk increases in people who are overweight. As the U.S. Hispanic population increases along with a growing prevalence of overweight and obesity, studies are needed to determine if overweight Hispanic adults suffer from disparities in their rates of CRC screening. Our study was able to examine the correlation between a preference for using the Spanish language and rates of screening for CRC using national survey data.


4,730 Hispanic participants, > 50 years, with a BMI > 25 kg/m2 from the 2006 Behavioral Risk Factor Surveillance System were stratified by survey language choice (English, n = 3,499; or Spanish, n = 1,231). Using adjusted logistic regression models, differences in receiving the recommended Fecal Occult Blood Test (F.O.B.T.) and/or either a colonoscopy or sigmoidoscopy were determined by language preference groups.


Men who chose surveys in Spanish were significantly less likely to have received F.O.B.T. (0.29 O.R.; 0.13-0.64 95% C.I.), sigmoidoscopy/colonoscopy (0.49 O.R.; 0.28-0.84 95% C.I.) or either test (0.46 O.R.; 0.27-0.79 95% C.I.) within the recommended time frames, compared to men choosing English. No significant differences were found among women.


Findings suggest that men with an elevated BMI who choose Spanish to complete a survey are less likely to receive the recommended CRC screening. Public health programs designed to improve access to CRC screening need to target this population in order to reduce the morbidity and mortality related to colorectal cancer.