Breast and Cervical Cancer Screening Utilization Among Hispanic Women Living Near the United States-Mexico Border Tomas Nun ˜ o, M.A., 1 Philip E. Castle, Ph.D., M.P.H., 2 Robin Harris, Ph.D., 1,3 Antonio Estrada, Ph.D., 4 and Francisco Garcı ´a, M.D., M.P.H., 1,3,5 for the Yuma Project Technical Team Abstract Objective: Hispanic women who reside in low-resource settings are especially at risk for nonparticipation in cancer screening programs. The purpose of this study was to assess characteristics that influence breast and cervical cancer screening among older Hispanic women living along the United States-Mexico border. Methods: A cross-sectional study of women aged ‡ 50 years (n = 504) residing in Yuma County, Arizona, were randomly selected for interviews. Logistic regression analyses were conducted to identify determinants of compliance with mammography and Pap smear use. Results: Women who received a recommendation from a clinician to get both mammography and Pap smears were more likely to receive a mammogram within the past year (adjusted odds ratio [AOR] 5.1, 95% confidence interval [CI] 3.0-8.9) compared to women who received no recommendation. Likewise, women who received both recommendations were more likely to receive a Pap smear within the past 3 years (AOR 9.7, 95% CI 4.6- 20.7) compared to women who received no recommendation. Other factors, such as current health insurance and a visit with their healthcare provider in the past year, were also associated with getting a mammogram within 1 year or Pap smear within 3 years. Conclusions: Enabling characteristics were significantly associated with breast and cervical cancer screening use compared to predisposing and need characteristics among older Hispanic women residing near the U.S.-Mexico border. Clinician recommendation of both mammograms and Pap smears and opportunistic clinic visits to medical providers may increase breast and cervical cancer screening coverage and reduce the burden of these two cancers in this high-risk population. Introduction C ancer is the second leading cause of death among Hispanics in the United States. 1 Breast cancer is the most common neoplasm among Hispanic women in terms of inci- dence (90.2/100,000) and mortality (15.6/100,000). 2 Despite a lower incidence and mortality compared to non-Hispanic white (NHW) women (126.9/100,000 and 24.4/100,000, re- spectively), 2 breast tumors in Hispanics are more likely to appear at a larger size and more advanced stage disease. 2–4 By comparison, cervical cancer has a higher incidence (12.7 vs. 7.3/100,000) and mortality (3.1 vs. 2.1/100,000) among His- panic women compared to their NHW counterparts. 2 Other national data continue to demonstrate a higher cervical cancer incidence among Hispanics (13.9 vs. 7.7/100,000). 5 This trend is particularly pronounced for foreign-born women living in the United States, who have experienced a 22% increase in cervical cancer mortality rates since 1985. 6 Along the United States-Mexico border, Hispanic women also have almost twice the cervical cancer incidence (13.9 vs. 7.0/100,000) compared to NHW women. 7 One major factor contributing to these disparities in cancer rates and outcomes is the underuse of cancer screening ser- vices. The best population-based estimate for this comes from the National Health Interview Survey (NHIS) performed by the Centers for Disease Control and Prevention (CDC). Per these estimates, Mexican-origin Hispanic women are less likely to have mammography within the past year (49%, compared to NHW women at 56%) or Pap smear within the past 3 years (73%, compared to NHW women at 80%), 2 as recommended by the American Cancer Society (ACS). Along the U.S.-Mexico border, these differences may be even more 1 Mel and Enid Zuckerman College of Public Health, 3 Arizona Cancer Center, 4 Mexican-American Studies and Research Center, and 5 Center of Excellence in Women’s Health, University of Arizona, Tucson, Arizona. 2 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland. JOURNAL OF WOMEN’S HEALTH Volume 20, Number 5, 2011 ª Mary Ann Liebert, Inc. DOI: 10.1089/jwh.2010.2205 685