Post-Pandemic Multidimensional Integration of Afghan Refugee Women in the U.S.

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States [] and is also among the leading causes of cancer mortality among Latinos, along with lung and pancreatic cancer []. Latinos, who represent 19% of the U.S. population [] and 10.5% of the population in Virginia [] have a CRC incidence of 38.2 and 27.5 per 100,000 for men and women, respectively []. Unlike long-established Latino enclaves in California, Florida, and Texas, Virginia’s Latino community is relatively new, composed largely of first-generation, Spanish-speaking immigrants from Central and South America who face limited access to insurance and preventive care. Despite CRC being among the most preventable cancers, Latinos who are 50 years or older are less likely to be screened for CRC, with the screening rates ranging from 48% to 50%, compared to a significantly higher rate of 65% among Whites []. Additionally, Latinos are more likely than Whites to be diagnosed at advanced stages of CRC [], which results in lower life expectancy and a reduced survival rate within five years of diagnosis [, ]. Studies have shown that Latinos are less aware of CRC risk factors and prevention strategies, and are more likely to engage in risky behaviors, such as lower screening rates, diets high in processed foods and low in fiber, physical inactivity, and higher obesity rates []. Obesity and type 2 diabetes, both linked to higher CRC risk, are more common among Latinos and often worsened by poor diet, low physical activity, and lifestyle changes associated with acculturation upon moving to the U.S [, ]. Although healthy habits like exercise, a balanced diet, and avoiding alcohol and smoking can lower the risk [, ] many Latinos continue to have high levels of these risk factors. Latinos also consume more alcohol than other immigrant minorities, increasing their CRC risk []. Limited access to healthcare and preventive services also contributes to poorer outcomes.