Journal of Obstetrics and Gynaecology Canada
Volume 41, Issue 6, 2019, Pages 824-831.e1

Is Immigrant Status Associated With Cervical Cancer Screening Among Women in Canada? Results From a Cross-Sectional Study (Article)

Bacal V.* , Blinder H. , Momoli F. , Wu K.Y. , McFaul S.
  • a School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada, Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada, Ottawa Hospital Research Institute, Ottawa, ON, Canada
  • b School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
  • c School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada, Ottawa Hospital Research Institute, Ottawa, ON, Canada, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
  • d Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
  • e Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada

Abstract

Objective: Cervical cancer accounts for the highest mortality rate from cancer in women worldwide. Despite widespread availability of cervical cancer screening programs in Canada, immigrant women are largely underscreened. The most recently published Canadian-wide study evaluated screening uptake from 2001 to 2002. The objectives included identifying the prevalence of underscreened women in Canada, determining the risk of underscreening for cervical cancer among immigrant women, and providing an update on Canadian screening practices. Methods: This study included women aged 20 to 69 who completed the Canadian Community Health Survey 2012. The prevalence of underscreening among Canadian-born and immigrant women was estimated. A log-binomial model was fit to estimate the relative risk (RR) of underscreening for immigrant women while controlling for age, income level, visible minority status, smoking status, and access to a regular physician. A secondary analysis compared immigrants residing in Canada for greater or less than 10 years to Canadian-born women. Results: Of the 17 854 women eligible for this study, 18.6% of Canadian-born women and 28.9% of immigrant women were underscreened (P < 0.05). Immigrant women were at significantly higher risk of being underscreened compared with Canadian-born women (RR 1.32; 95% CI 1.20–1.45). The relative risk did not change when stratifying by length of time since immigration (RRrecent immigrant 1.32; 95% CI 1.16–1.50; and RRlong-term immigrant 1.32; 95% CI 1.19–1.47). Conclusion: Immigrant status continues to be associated with a significantly higher risk of underscreening, irrespective of time in Canada. Social and educational programs targeted towards immigrants are needed to mitigate the disparity in cervical cancer screening. © 2018 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada.

Author Keywords

uterine or cervical neoplasms/prevention and control mass screening/organization and administration papillomavirus infections/diagnosis Uterine or cervical neoplasms/epidemiology social determinants of health/statistics and numerical data emigrants and immigrants/statistics and numerical data

Index Keywords

educational status immigrant minority group immigration human controlled study Aged cancer screening income cross-sectional study smoking Canada female prevalence Canadian Article adult uterine cervix cancer age hysterectomy health care access Papanicolaou Test
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85055089339&doi=10.1016%2fj.jogc.2018.07.010&partnerID=40&md5=1b4ab41f7b9d517ff3709340d0b38897
DOI: 10.1016/j.jogc.2018.07.010
ISSN: 17012163
Original Language: English