Using 2007 California Health Interview Survey (CHIS) data, authors examined the relationship between low health literacy (LHL), limited English proficiency (LEP), and meeting current U.S. Preventive Service Task Force colorectal cancer (CRC) screening guidelines for Asians and Whites in California.

Overall, respondents with LEP and LHL were the least likely to meet CRC screening guidelines (36 percent) followed by LEP-only (45 percent), LHL-only (51 percent), and those with neither LHL nor LEP (59 percent). For Whites, LHL-only was associated with screening, whereas LEP-only and LEP and LHL were significant for Asians. Having a language concordant provider was not significantly associated with CRC screening among those with LEP. Health literacy is associated with CRC screening, but English proficiency is also critical to consider. Asians with both LEP and LHL appear particularly vulnerable to cancer screening disparities.