BMC Public Health
Volume 14, Issue 1, 2014

Who are the under- and never- Screened for cancer in Ontario: A qualitative investigation (Article) (Open Access)

Gesink D.* , Mihic A. , Antal J. , Filsinger B. , Racey C.S. , Perez D.F. , Norwood T. , Ahmad F. , Kreiger N. , Ritvo P.
  • a Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada
  • b Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada
  • c Cancer Care Ontario, Toronto, ON, Canada
  • d Cancer Care Ontario, Toronto, ON, Canada
  • e Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada
  • f York University, Toronto, ON, Canada
  • g Cancer Care Ontario, Toronto, ON, Canada
  • h York University, Toronto, ON, Canada
  • i Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada, Cancer Care Ontario, Toronto, ON, Canada
  • j Cancer Care Ontario, Toronto, ON, Canada, York University, Toronto, ON, Canada

Abstract

Background: Observed breast, cervical and colon cancer screening rates are below provincial targets for the province of Ontario, Canada. The populations who are under- or never-screened for these cancers have not been described at the Ontario provincial level. Our objective was to use qualitative methods of inquiry to explore who are the never- or under-screened populations of Ontario. Methods. Qualitative data were collected from two rounds of focus group discussions conducted in four communities selected using maps of screening rates by dissemination area. The communities selected were archetypical of the Ontario context: urban, suburban, small city and rural. The first phase of focus groups was with health service providers. The second phase of focus groups was with community members from the under- and never- screened population. Guided by a grounded theory methodology, data were collected and analyzed simultaneously to enable the core and related concepts about the under- and never-screened to emerge. Results: The core concept that emerged from the data is that the under- and never-screened populations of Ontario are characterized by diversity. Group level characteristics of the under- and never- screened included: 1) the uninsured (e.g., Old Order Mennonites and illegal immigrants); 2) sexual abuse survivors; 3) people in crisis; 4) immigrants; 5) men; and 6) individuals accessing traditional, alternative and complementary medicine for health and wellness. Under- and never-screened could have one or multiple group characteristics. Conclusion: The under- and never-screened in Ontario comprise a diversity of groups. Heterogeneity within and intersectionality among under- and never-screened groups adds complexity to cancer screening participation and program planning. © 2014 Gesink et al.; licensee BioMed Central Ltd.

Author Keywords

qualitative methods Ethics Cancer screening Sexual abuse Mennonites

Index Keywords

urban population medically uninsured Neoplasms human middle aged Ethnic Groups rural population health service statistics and numerical data Colonic Neoplasms ethnic group Early Detection of Cancer procedures Health Services Needs and Demand Humans Breast Neoplasms male Canada female Ontario adult Uterine Cervical Neoplasms Healthcare Disparities health care disparity early diagnosis
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84901758977&doi=10.1186%2f1471-2458-14-495&partnerID=40&md5=27a7f5ec4d1953d98ab1d1291fbf37ff
DOI: 10.1186/1471-2458-14-495
ISSN: 14712458
Cited by: 22
Original Language: English