BARRIERS TO CANCER SCREENING IN MEXICAN-AMERICAN WOMEN

Objective: To test the simultaneous effect of various established pred ictors of breast and cervical cancer screening (breast self-examinatio n, clinical breast examination by a physician, Papanicolaou [Pap] smea r, and pelvic examination) in a low-income, Mexican-American sample. M aterial and Methods: A total of 188 Mexican-American women participate d in a face-to-face structured interview in their preferred language. We tested a model with four established predictors of breast and cervi cal cancer screening-communication skills, knowledge of cancer, access to health care (finances and availability of care), and anxiety about cancer, Simultaneous structural equations analysis was used to form l atent variables and to control for the effect of all predictors concur rently. Results: Screening behavior was inversely associated with anxi ety about cancer when all other predictors were statistically controll ed, In addition, anxiety substantially affected the relationship betwe en communication skills and screening behavior, Unexpectedly, knowledg e of cancer was positively, rather than negatively, associated with an xiety about cancer, Predictors in the model demonstrated an excellent fit of the proposed model to the data. Conclusion: Successful cancer s creening programs for Mexican-American women must address not only acc ess barriers but also communication skills, knowledge, and, perhaps mo st importantly, anxiety.