Time in the U.S. and Colorectal Cancer Screening Adherence Among Diverse Immigrants.

Background: Colorectal cancer screening rates are lower among immigrants compared to U.S.-born individuals. This study examined the association between time spent in the U.S. and CRC screening adherence in a diverse sample of immigrants, while considering the role of sociodemographic factors.

Methods: Data from the 2010, 2013, 2015, and 2018 NHIS were analyzed. The sample included 6,298 immigrants aged 50-75. Multivariable logistic regression was used to assess the association between time in the U.S. (<15 years vs. ≥15 years) and CRC screening adherence, adjusting for sociodemographic factors.

Results: Overall, 47.6% of immigrants adhered to CRC screening guidelines. Immigrants residing in the U.S. for 15 years or more had significantly higher odds of screening adherence (AOR = 1.63; 95% CI, 1.29-2.05) compared to those with less than 15 years of residence in the U.S. This association varied by race/ethnicity, with the greatest impact seen among Asian immigrants. Socioeconomic factors, particularly education and having a usual source of care, were also significantly associated with screening adherence.

Conclusions: Time in the U.S. is a significant predictor of CRC screening adherence among immigrants, with those residing 15 years or more showing higher adherence across racial and ethnic groups. Socioeconomic factors, including education, income, health insurance, and having a usual place of care, are strongly associated with screening adherence across all immigrant groups. These findings underscore the need for tailored interventions to enhance screening rates, particularly among recent immigrants and those with limited socioeconomic resources.