European Journal of Cancer Prevention
Volume 25, Issue 4, 2016, Pages 321-328

Cervical cancer screening in immigrant women in Italy: A survey on participation, cytology and histology results (Review)

Campari C. , Fedato C. , Iossa A. , Petrelli A. , Zorzi M. , Anghinoni E. , Bietta C. , Brachini A. , Brezzi S. , Cogo C. , Giordano L. , Giorgi D. , Palazzi M. , Petrella M. , Schivardi M.R. , Visioli C.B. , Rossi P.G.*
  • a Planning and Control Staff, AUSL Reggio Emilia, Italy, IRCCS-Arcispedale Santa Maria Nuova, Italy
  • b Veneto Cancer Registry, Veneto Region, Padua, Italy
  • c ISPO Institute for Cancer Study and Prevention, Florence, Italy
  • d INMP National Institute for Health, Migration and Poverty (NIHMP), Rome, Italy
  • e Veneto Cancer Registry, Veneto Region, Padua, Italy
  • f Department of Prevention, ASL di Mantova, Mantova, Italy
  • g UOSD Epidemiology, Cytologic Screening, USL Umbria 1, Umbria, Italy
  • h Screening Program Unit, AUSL Viterbo, Viterbo, Italy
  • i Screening Program Unit, AUSL Viterbo, Viterbo, Italy
  • j Veneto Cancer Registry, Veneto Region, Padua, Italy
  • k Screening Program Unit, AUSL Viterbo, Viterbo, Italy
  • l Epidemiology Unit, CPO Piemonte, Piemonte, Italy
  • m Department of Prevention, SC Epidemiology and Screening, AUSL 2 Lucca, Lucca, Italy
  • n UOSD Epidemiology, Cytologic Screening, USL Umbria 1, Umbria, Italy
  • o AUSL Romagna, Cesena and MUO Community Preventive Medicine, Screening Unit, ASL Brescia, Brescia, Italy
  • p ISPO Institute for Cancer Study and Prevention, Florence, Italy
  • q IRCCS-Arcispedale Santa Maria Nuova, Italy, Inter-institutional Epidemiology Unit, AUSL, Reggio Emilia, 42122, Italy

Abstract

Cervical cancer screening programmes in Italy actively invite all 25-64-year-old resident women for the Pap test every 3 years irrespective of their citizenship. Immigrant women come from countries where screening is absent or poorly implemented and the prevalence of human papillomavirus is often high. These women therefore have significant risk factors for cervical cancer. The Italian Group for Cervical Cancer Screening promoted a survey of all the screening programmes on the participation and the positivity and detection rates in Italian and foreign women in 2009-2011. Aggregated data for participation, cytology results, compliance with colposcopy and histology results were collected, distinguishing between women born in Italy and abroad. All comparisons were age adjusted. Forty-eight programmes out of 120 participated in the immigrant survey, with 3 147 428 invited and 1 427 412 screened Italian women and 516 291 invited and 205 948 screened foreign women. Foreign women had a slightly lower participation rate compared with Italians (39.9 vs. 45.4%), whereas compliance with colposcopy was similar (90%). Foreigners showed a higher risk of pathological findings than Italians: cytology positivity [relative risk (RR)=1.25, 95% confidence interval (CI) 1.24-1.27] and detection rate for cervical intraepithelial neoplasia grade 2 (CIN2) (RR=1.39, 95% CI 1.31-1.47), CIN3 (RR=2.07, 95% CI 1.96-2.18) and cancer (RR=2.68, 95% CI 2.24-3.22). The ratio between cancer and CIN was higher in immigrants (0.06 vs. 0.04, P>0.01). Foreign women had a higher risk of cervical precancer and cancer. Because of their high risk and because opportunistic screening does not cover this often disadvantaged group, achieving high participation in screening programmes for foreigners is critical to further reducing the cervical cancer burden in Italy. © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Author Keywords

Cervical cancer Screening Cervical intraepithelial neoplasia immigrants Pap test

Index Keywords

Vaginal Smears immigrant cancer patient cytology Follow-Up Studies follow up histology human middle aged statistics and numerical data priority journal pathology early cancer diagnosis precancer cancer screening cancer risk comparative study Aged Early Detection of Cancer prognosis resident Wart virus Surveys and Questionnaires health program Humans migrant Emigrants and Immigrants female risk factor Review questionnaire prevalence squamous cell carcinoma Carcinoma, Squamous Cell colposcopy major clinical study adult uterine cervix cancer patient participation Uterine Cervical Neoplasms utilization Papanicolaou Test Cervical Intraepithelial Neoplasia uterine cervix carcinoma in situ uterine cervix tumor Italy vagina smear health survey
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84973563644&doi=10.1097%2fCEJ.0000000000000173&partnerID=40&md5=bdfd968689238b6d196664c544c8b929
DOI: 10.1097/CEJ.0000000000000173
ISSN: 09598278
Cited by: 7
Original Language: English