Table 1 presents the descriptive characteristics of the sample. The weighted sample included 82% US-born and 18% foreign-born. Approximately 11% of the sample indicated that they had a cancer diagnosis. The percentage of US-born individuals who had a self-reported cancer diagnosis was more than twice that of foreign-born individuals (12% vs. 5%, p<0.001). The unweighted mean age of the sample was 49.75, median 50, and interquartile range 30. The weighted average age of the sample was 47.78. On average, foreign-born natives were younger than US-born. The weighted average age was 45.56 among foreign-born compared to 48.28 among US-born natives. More than one-third (64%) of the foreign-born natives were between the ages of 20 and 50, compared to (54%) US-born. A larger percentage of foreign-born was within the age group 51-64 versus US-born (36.3 vs. 26.3, p<0.001). Within age group 65-80, US-born accounted for a larger percentage (20.5% vs. 13.8%, p<0.001). The percentage of females was slightly higher than males (52% vs. 48%). There was almost an equal percentage of foreign-born and US-born males (49% vs. 48%) and an even split among foreign-born and US-born females (52% vs. 52%). Most of the weighted sample was non-Hispanic White (65%), followed by non-Hispanic Black (11%). Mexican Americans and other Hispanics accounted for 15%, with 9% and 6% for each group, respectively. US-born non-Hispanic Whites account for a higher percentage than foreign-born Whites (75% vs. 15%, p< 0.001). US-born non-Hispanic Blacks made up a larger percentage of the sample than foreign-born Blacks (13% vs. 7%, p<0.001). On the other hand, US-born Mexican Americans made up a smaller percentage than foreign-born Mexican Americans (5% vs. 26%, p<0.001). There was a similar pattern with US-born Other Hispanics vs foreign-born Other Hispanics (3% vs. 26. %, p < 0.001), US-born Asians vs. foreign-born Asians (1% vs. 26%, p<0.001) and those who were US-born of other races vs. foreign-born (2% vs. 3%, p<0.001).
Most of the respondents received routine care in at least one location (84%). US-born individuals received routine care at a higher rate than foreign-born (85% vs.77%, p <0.001). Over one-third (36%) of the sample reported being told that they were overweight by their doctor and more US-born individuals reported being overweight compared to foreign-born (40% vs. 27%). Less than half of the sample were smokers who either smoked in the past or were current smokers (43%). However, US-born individuals were more likely to be smokers than foreign-born (46% vs. 31%, p = <0.001).
Table 2 shows the multivariate logistic regression examining the association between nativity and cancer diagnosis after adjusting for routine care, being overweight, smoking status, race/ethnicity, gender, and age. In Model 1, we adjusted for age as a continuous variable using logistic regression. We found that nativity was significantly associated with a cancer diagnosis. US-born individuals were more likely to report a self-reported cancer diagnosis compared to their foreign-born counterparts (OR = 2.34, 95% CI [1.93; 2.83], p<0.001). With each unit increase in age, there was a higher odds of a self-reported cancer diagnosis (OR=1.07, 95% CI [1.06; 1.07], p<0.001). In the fully adjusted model, nativity was significantly associated with a self-reported cancer diagnosis. US-born individuals were more likely to report a cancer diagnosis compared to their foreign-born counterparts (OR=1. 39, 95 % CI [1.05; 1.84], p<0.05). The association between age and self-reported cancer did not vary from the first model (OR= 1.06, 95% CI [1.06; 1.07], p<0.001). Mexican Americans, other Hispanics, non-Hispanic Blacks, and Asians were significantly less likely to report having cancer compared to non-Hispanic Whites (OR=0.46, 95% CI [0.36; 0.58], p<0.001), (OR=0.60, 95% CI [0.42, 0.86], p<0.001), (OR=0.40, 95% CI [0.36; 0.45], p<0.001), (OR=0.37, 95% CI [0.27; 0.51], p<0.001), respectively. Males were significantly less likely to report having been told they had cancer compared to females (OR=0.87, 95% CI [0.76; 1.0], p<0.05). Individuals who had a place of routine care were more likely to have been told they have cancer (OR=1.48, 95% [1.14; 1.93], p<0.001). Those that were overweight were more likely to have reported a cancer diagnosis compared to those who were not overweight (OR 1.16, 95% CI [1.01; 1.34], p<0.05). Smokers were more likely to report having been diagnosed with cancer (OR 1.30, 95% CI [1.13; 1.49], p<0.001). We performed a sensitivity analysis with age categorized (20 -34); (35-50); (51-64); and (65-80) with the youngest age group as the reference group. There were no significant differences in the results from age as a continuous variable.
There was not a significant association between nativity and self-reported cancer diagnosis among non-Hispanic Whites (OR =1.35, 95% CI [0.87;2.08], p =0.17). With each unit increase in age, there was a higher odds of a self-reported cancer diagnosis among non-Hispanic Whites (OR=1.07, 95% CI [1.06; 1.07], p<0.001). Non-Hispanic White smokers were also more likely to report being diagnosed with cancer than non-Hispanic White nonsmokers (OR= 1.27, 95% CI [1.08;1.5], p<0.05). There was no significant difference based on gender, routine care, or being overweight (OR=0.90, 95% CI [0.76;1.07], p=0.23), (OR=1.27, 95% CI [0.95;1.71], p=0.06), (OR=1.16, 95% CI [0.99;1.36], p=0.11), respectively.
There was no significant association with nativity and self-reported cancer among Mexican Americans (OR=0.98, 95% CI [0.62;1.60], p=0.94). With each unit increase in age, there was a higher odds of a self-reported cancer diagnosis among Mexican Americans (OR=1.06, 95% CI [1.05;1.08], p<0.001). Mexican American males compared to Mexican American females were significantly less likely to report a cancer diagnosis (OR=0.32, 95% CI [0.20;0.49], p<0.001). Among this group, there was a higher odds of a self-reported cancer diagnosis among those who reported having routine care compared to those who did not receive routine care (OR=2.35, 95% CI [1.20;4.60], p<0.05). Mexican American smokers had significantly higher odds of reporting a cancer diagnosis than nonsmokers (OR=1.07, 95% CI [1.16;2.67], p<0.05.), but there was no significant relationship between being overweight and a reported cancer diagnosis among Mexican Americans (OR=1.07, 95% CI [ 0.73;1.57], p=0.72).
Among the other Hispanic group, there was a significant association between self-reported cancer diagnosis and age (OR =1.04, 95% CI [1.03;1.06], p<0.001) and routine care (OR=3.96, 95% CI [1.60;9.77], p<0.05). There was not a significant association between nativity and self-reported cancer diagnosis (OR=1.19, 95% CI [0.76;1.86], p=0.44), gender (OR=. 0.64, 95%, CI [0.39;1.06], p=0.08), being overweight (OR=0.99, 95% [CI [0.60;1.62], p=0.96), and smoking (OR=1.32, 95% CI [0.91;1.91], p=0.14).
Among Asians, there was no significant association between nativity and self-reported diagnosis (OR=1.52, 95% CI [0.85;2.77], p=0.17). An increase in age among this group showed a significant likelihood of self-reported cancer (OR=1.08, 95% CI [1.06;1.09], p<0.001). Asian males were significantly less likely to report having cancer diagnosis than Asian females (OR=0.39, 95% CI [0.23;0.59], p<0.001). There was no significant relationship between routine care, overweight and smoking among and self-reported cancer among this group (OR=1.50, 95% CI [0.62;3.63], p=0.36); (OR=1.58, 95% CI [0.90;2.80], p=0.11); (OR=1.16, 95% CI [0.60;2.22], p=0.66), respectively.
While there was no significant association between nativity and self-reported diagnosis among the group, “Other race” (OR=2.21, 95% CI [0.78;6.31], p=0.135), there was an association between age and self-reported cancer diagnosis as with all racial groups (OR=1.07, 95% CI [1.03;1.10], p < 0.001). Smokers were significantly more likely to report a cancer diagnosis compared to non-smokers (OR=3.98, 95% CI [1.56;10.20], p < 0.001). Gender, routine care and being overweight were not significantly associated with a cancer self-diagnosis (OR=0.81, 95% CI [0.37;1.79], p = 0.60), (OR=2.00, 95% [CI 0.60;6.72], p = 0.26), (OR=1.48, 95% [CI 0.63;3.46], p = 0.36), respectively.