Cervical Cancer Screening Adherence Among Somali Immigrants and Refugees to the United States

Abstract

Somali women have lower cervical cancer screening (CCS) rates than non-Somali women in the United States. We examined clinical and administrative data associated with CCS adherence among Somali women seen at a large primary care practice over 2 years. Fifty-one percent of 310 women were adherent to CCS, and adherence was associated with more overall health care system visits. Patients saw male providers 65.8% of the time; however, only 20.4% of the CCS tests were performed by male providers. Future interventions that enhance cancer prevention, health literacy, and patient-provider gender concordance may improve rates of CCS among Somali women.

Barriers to cervical cancer screening: A qualitative study among Somali women in Oslo Norway

“…The study findings that the Pap smear test was perceived as potentially conflicting with cultural and religious values about sexuality and modesty, considered invasive, and understood as potentially compromising the virginity of young and unmarried women are consistent with a previous study among Somali women [18], as well as with a recent study among Pakistani and Somali women in Oslo that found that unmarried women are not expected to undergo screening due to cultural and religious expectations that they remain sexually inactive until married [9]The study findings that the research participants prefered female practitioners and avoided screening due to concern that they might be met by a male practitioner are also similar to the findings of previous studies conducted among Somali women [13,15]. Also consistent with other studies was that the participants believed that the presence or absence of disease was a matter of God's will, which also then coincided with fatalistic attitudes about not only the development of cervical cancer, but also its outcome [13,20,21]. That most of the participants stated that they did not believe in getting cervical cancer and therefore did not need to be screened suggests that religious beliefs have an important influence on health decisions and health seeking behaviour.…”

Addressing cancer control needs of African-born immigrants in the US: A systematic literature review

“…Ten out of 11 identified studies focused on cervical cancer detection (pap smear screening) and most were quantitative studies based on cross-sectional surveys or medical record abstractions 23,26,32,36,37,40 and included other types of cancer in addition to cervical cancer. 23,26,32,36,37,40 There were four qualitative studies 35,38,41,42 and one intervention study.…”

“…23,26,32,36,37,40 There were four qualitative studies 35,38,41,42 and one intervention study. 32 Only one study was conducted in the UK.…”

“…Morrison and colleagues 40 found that Somali patients had lower rates of colorectal cancer screening compared to non-Somali patients (38.46% vs. 73.35%). Higher screening was correlated with higher use of primary care services.…”

“…Caribbean, Latin American), or categorize them as “Black, ” “other Africans,” or “non-Caribbean” without specifying participants’ nationalities. 24,26,31,42,47,48 Carefully, examining differences by subgroups is important because the studies that differentiate African born immigrants from other subpopulations suggest that there are important differences in cancer risks, cancer screening, and cancer perceptions and experiences between African born immigrants and US born populations, 23,26,40,47 US born Black, 24,48 and with immigrants from other non-African countries. 36 Moreover, differences were reported between African immigrants from different nationalities, 37 between Africans who migrated and who did not migrate, 43,49 and even between different ethnic groups within the same African country.…”