Medical Care
Volume 48, Issue 7, 2010, Pages 611-618

Low rates of cervical cancer screening among urban immigrants: A population-based study in ontario, Canada (Article)

Lofters A.K. , Moineddin R. , Hwang S.W. , Glazier R.H.
  • a Department of Family and Community Medicine, University of Toronto, Toronto, Canada, Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada, Centre for Research on Inner City Health, Keenan Research Centre, St. Michael's Hospital, Toronto, Canada, Canadian Institutes of Health Research Strategic Training Fellow, Transdisciplinary Approach to the Health of Marginalized Populations, Toronto, Canada
  • b Department of Family and Community Medicine, University of Toronto, Toronto, Canada, Institute for Clinical Evaluative Sciences, Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  • c Centre for Research on Inner City Health, Keenan Research Centre, St. Michael's Hospital, Toronto, Canada, Department of Medicine, University of Toronto, Toronto, Canada
  • d Department of Family and Community Medicine, University of Toronto, Toronto, Canada, Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada, Centre for Research on Inner City Health, Keenan Research Centre, St. Michael's Hospital, Toronto, Canada, Institute for Clinical Evaluative Sciences, Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

Abstract

OBJECTIVE: Women who are immigrants or socioeconomically disadvantaged have been found to have significantly lower cervical cancer screening rates than their peers in Toronto, Ontario, Canada. The objective of this study was to examine rates of appropriate cervical cancer screening among women living in Ontario, Canada, using recent registration with Ontario's universal health insurance plan as an indicator of immigrant status. METHODS: This retrospective cohort study included 2,273,995 screening-eligible women aged 25 to 69 years, who resided in Ontario's metropolitan areas during the calendar years 2003, 2004, and 2005. A validated algorithm was applied to the Ontario-wide physiciansclaims database to determine which women had undergone cervical cancer screening with a Pap test during the 3-year period. RESULTS: Appropriate cervical cancer screening occurred for 61.1% of women. Despite adjustment for physician contact and pregnancy rates, cervical cancer screening rates were especially low among: women aged 50 to 69 years; women living in low-income areas; and women who had registered with Ontario'universal health insurance plan within the preceding 10 years, a group consisting largely of recent immigrants. Women with all 3 of these characteristics had a screening rate of 31.0% compared with 70.5% among women with none of these characteristics. CONCLUSION: Within a system of universal health insurance, appropriate cervical cancer screening is significantly lower among women who are older, living in low-income areas, or recent immigrants. Efforts to reduce disparities in cervical cancer screening should focus on women with these characteristics. Copyright © 2010 by Lippincott Williams & Wilkins.

Author Keywords

Mass screening papanicolaou smears immigrants Socioeconomic factors

Index Keywords

Vaginal Smears Vulnerable Populations urban population lowest income group mass screening poverty health insurance human pregnancy rate middle aged Cohort Studies controlled study priority journal Aged sensitivity analysis cancer screening Urbanization Humans Canada Emigrants and Immigrants female Article Retrospective Studies Ontario major clinical study adult uterine cervix cancer Uterine Cervical Neoplasms Papanicolaou Test Universal Coverage
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77954084631&doi=10.1097%2fMLR.0b013e3181d6886f&partnerID=40&md5=9af0e8f709c0acc54c446eedb3faf80d
DOI: 10.1097/MLR.0b013e3181d6886f
ISSN: 00257079
Cited by: 53
Original Language: English