# Guideline-concordant cancer screening among Deaf, DeafBlind, and Hard of Hearing (DDBHH) Puerto Ricans who use American Sign Language

## TL;DR

This study examines cancer screening rates among Deaf and Hard of Hearing Puerto Ricans who use sign language, revealing higher adherence than previously reported.

## Contribution

The study introduces accessible research methods to reach Deaf and Hard of Hearing Puerto Rican sign language users, a previously excluded population.

## Key findings

- Screening adherence for cervical, breast, and colorectal cancer was 69%, 80%, and 64%, respectively.
- Colorectal cancer screening rates exceeded those of the general Puerto Rican population.
- Accessible methods successfully reached Deaf and Hard of Hearing Puerto Rican sign language users.

## Abstract

Puerto Ricans who are Deaf, DeafBlind, and Hard of Hearing (DDBHH) and use sign language are excluded from cancer screening surveillance systems that are conducted primarily in English or Spanish. This exclusion resulted in limited data on screening behaviors among this population.

We administered a brief National Cancer Institute’s Health Information National Trends Survey (HINTS) to age-eligible Puerto Rican adults through deaf Puerto Rican team members. This survey included items that asked about cancer screenings in American Sign Language (ASL) and English.

Screening adherence was 69% for cervical cancer, 80% for breast cancer, and 64% for colorectal cancer. These rates exceed the colorectal cancer screening rate reported for the general Puerto Rican population (55%).

This first assessment of cancer screening behaviors among Deaf, DeafBlind, and Hard of Hearing Puerto Rican sign language users demonstrates that accessible research methods can successfully reach some of excluded populations and documents screening adherence within this population for the first time, while highlighting critical needs to implement evidence-based sign language-fluent health navigation services in Puerto Rico to achieve screening targets and reach Puerto Rican Sign Language-dominant users.