Preventive Medicine
Volume 44, Issue 6, 2007, Pages 536-542

Inadequacy of cervical cancer screening among urban recent immigrants: A population-based study of physician and laboratory claims in Toronto, Canada (Article)

Lofters A. , Glazier R.H.* , Agha M.M. , Creatore M.I. , Moineddin R.
  • a Department of Family and Community Medicine, University of Toronto, Toronto, Canada, Department of Family and Community Medicine, Mt. Sinai Hospital, Toronto, Canada, Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada
  • b Department of Family and Community Medicine, University of Toronto, Toronto, Canada, Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Canada, Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada, Institute for Clinical Evaluative Sciences, Toronto, Canada, Department of Public Health Sciences, University of Toronto, Toronto, Canada
  • c Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada, Department of Public Health Sciences, University of Toronto, Toronto, Canada
  • d Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Canada
  • e Department of Family and Community Medicine, University of Toronto, Toronto, Canada, Institute for Clinical Evaluative Sciences, Toronto, Canada, Department of Public Health Sciences, University of Toronto, Toronto, Canada

Abstract

Objective.: In Canada, Pap smears are recommended from 18 to 69. Self-reported socioeconomic gradients in screening have been documented in North America but there have been few direct measures of Pap smear use among immigrants or socially disadvantaged groups. Our purpose was to investigate whether socioedemographic factors are related to cervical cancer screening in Toronto, Canada. Method.: Pap smears were identified using fee and laboratory codes in Ontario physician service claims for 3 years (2000-2002 inclusive) for women aged 18-66. Area-level socioeconomic factors were derived from the 2001 census. At the individual level, recent registrants for health coverage, over 80% of whom are expected to be recent immigrants, were identified as women first registering after January 1, 1993. Results.: Among 724,584 women, 55.4% had Pap smears within 3 years. Recent immigration, visible minority, foreign language, low income and low education were all associated with significantly lower area rates. Recent registrants had much lower rates than non-recent registrants (36.9% versus 60.9%). Conclusion.: Pap smear rates in Toronto fall below those dictated by evidence-based practice. Recent registrants, a largely immigrant group, have particularly low rates. Efforts to improve coverage need to emphasize women who recently immigrated and those with socioeconomic disadvantage. © 2007 Elsevier Inc. All rights reserved.

Author Keywords

Pap smear Socioeconomic status Cervical cancer screening Administrative data Immigration

Index Keywords

Vaginal Smears education urban area Communication Barriers immigrant educational status Registries lowest income group mass screening Health Care Surveys demography minority group human Self Report middle aged priority journal Aged cancer screening language Urban Health Residence Characteristics evidence based practice North America Humans Adolescent Minority Groups Canada female Socioeconomic Factors socioeconomics population research cancer registry Article women's health Ontario major clinical study adult uterine cervix cancer Practice Guidelines Quality of Health Care Uterine Cervical Neoplasms Papanicolaou Test Emigration and Immigration Insurance Claim Reporting
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-34249337414&doi=10.1016%2fj.ypmed.2007.02.019&partnerID=40&md5=e457fe736a0295b446d2d7be6ee12ec7
DOI: 10.1016/j.ypmed.2007.02.019
ISSN: 00917435
Cited by: 77
Original Language: English