Acculturation and breast cancer screening in Latina women: Unraveling reasons for mixed results over 44 years of research

Abstract

In the quest to identify factors that contribute to health disparities in Latina women, acculturation has been examined as a correlate of breast cancer screening. Results have been equivocal, showing no relation, a positive, or a negative relation. In this article, we examined reports of this association over a span of 44 years (1980–2023) to identify reasons for inconsistent results across studies, deriving implications and recommendations for theory building and research. A comprehensive PRISMA review yielded 44 empirical articles with a total sample of over 32,130 Latina women. Through a rigorous process, we uncovered how acculturation has been conceptualized and measured, as well as the nature of the association between acculturation and breast cancer screening across studies. In the 43 studies for which information was available, acculturation was measured 35 different ways. Only seven articles included a definition of acculturation and a conceptualization linking the construct to screening. Findings were mixed; the highest proportion of studies showed no link across constructs. Inconsistent results may be due to (a) a lack of clear definitions or conceptualizations, (b) the use of proxies and unilinear measures, (c) the use of modified and unvalidated measures, and (d) large sample variation across age, ancestry, and geographic location. Given inconsistent findings, no definitive conclusions can be made regarding the association between acculturation and screening behaviors. Results suggest that in future studies, acculturation should be measured as a latent construct with a greater focus on structural factors that may contribute to low screening rates