Trends in Cancer Screening by Citizenship and Health Insurance, 2000–2010

While early detection through screenings for breast, cervical, and colorectal cancer is essential in improving cancer survival, it is not evenly utilized across class, race, ethnicity, or nativity. Given that utilization of early detection through screenings is not evenly distributed, immigrants who have much lower rates of health insurance coverage are at a disadvantage. We use National Health Interview Survey data linked with the Medical Expenditures Panel Survey to examine the trend in screening rates for breast, cervical, and colorectal cancer from 2000 to 2010, comparing U.S.-born natives, foreign-born citizens, and foreign-born non-citizens. We find that citizenship is clearly advantageous for the foreign-born, and that screening rates are higher among citizens compared to non-citizens overall, but uninsured non-citizens sometimes have higher screening rates that uninsured natives. Health insurance is pivotal for higher screening rates with clear differences among the insured and uninsured. Policies aimed at reducing disparities in cancer screening need to take into account nativity, citizenship, and access to health insurance.