Cervical Cancer Screening among Women from Muslim-Majority Countries in Ontario, Canada

Lofters, Aisha; Vahabi, Mandana; Kim, Eliane; Ellison, Lisa; Graves, Erin; Glazier, Richard H.

doi:10.1158/1055-9965.epi-17-0323

Cited by 32 publications

(23 citation statements)

References 19 publications

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“…Similar to breast cancer screening [10][11][12], many studies conducted in Europe have shown that migrant women participate in cervical cancer screening less frequently than the respective majority populations [13][14][15][16][17]. Comparable findings were reported from other regions of the world such as the United States [18], Canada [19] and Australia [20]. By means of multivariable analyses, all of these studies also showed that differences between migrant and non-migrant females with respect to the utilization of cervical cancer screening are only partially attributable to the influence of demographic and socioeconomic factors.…”

Section: Introductionmentioning

confidence: 94%

Utilization of cervical cancer screening among migrants and non-migrants in Germany: results from a large-scale population survey

2020

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Background: Studies from European and non-European countries have shown that migrants utilize cervical cancer screening less often than non-migrants. Findings from Germany are inconsistent. This can be explained by several limitations of existing investigations, comprising residual confounding and data which is restricted to only some regions of the country. Using data from a large-scale and nationwide population survey and applying the Andersen Model of Health Services Use as the theoretical framework, the aim of the present study was to examine the role that different predisposing, enabling and need factors have for the participation of migrant and non-migrant women in cervical cancer screening in Germany. Methods: We used data from the 'German Health Update 2014/2015' survey on n = 12,064 women ≥20 years of age. The outcome of interest was the participation in cancer screening (at least once in lifetime vs. no participation). The outcome was compared between the three population groups of non-migrants, migrants from EU countries and migrants from non-EU countries. We employed multivariable logistic regression to examine the role of predisposing, enabling and need factors. Results: Non-EU and EU migrant women reported a lower utilization of cervical cancer screening (50.1 and 52.7%, respectively) than non-migrant women (57.2%). The differences also remained evident after adjustment for predisposing, enabling and need factors. The respective adjusted odds ratios (OR) for non-EU and EU migrants were OR = 0.67 (95%-CI = 0.55-0.81) and OR = 0.80 (95%-CI = 0.66-0.97), respectively. Differences between migrants and non-migrants were particularly pronounced for younger age groups. Self-rated health was associated with participation in screening only in non-migrants, with a poorer health being indicative of a low participation in cancer screening. Conclusions: The disparities identified are in line with findings from studies conducted in other countries and are indicative of different obstacles this population group encounters in the health system. Implementing patientoriented health care through diversity-sensitive health services is necessary to support informed decision-making.

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Section: Introductionmentioning

confidence: 94%

Utilization of cervical cancer screening among migrants and non-migrants in Germany: results from a large-scale population survey

2020

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“…It could be the case that women born in these countries have better knowledge about the Australian health care system and the availability of screening services than women born in other Muslim countries. It is also likely that the differences in cultural values over religious affiliation may play a role in the differences in screening participation [22]. Instead of visiting a general practitioner, for breast screening women have to make an appointment and travel to a different facility.…”

Section: Plos Onementioning

confidence: 99%

Understanding the participation of breast screening among women born in predominantly Muslim countries living in Victoria, Australia from record-linkage data

et al. 2020

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Background Early detection of breast cancer can improve survival rates and decrease mortality rates. This study investigates whether there are significant differences in participation in breast screening among women born in Muslim countries compared to women born in Non-Muslim countries and Australia. Methods Screening data from January 1 st , 2000 to December 31 st , 2013 from the Breast Screen Victoria Registry (BSV) was linked with hospital records from the Victorian Admitted Episodes Dataset (VAED). Countries having more than 50% of their population as Muslim were categorised as Muslim countries. Age adjusted rates were calculated for women born in Muslim and Non-Muslim countries and compared with the Australian age adjusted rates. Logistic regression assessed the association between screening status and other factors which include country of birth, marital status, age and socioeconomic status. Results Women born in Muslim countries (Odds Ratio (OR) = 0.70, 95%CI = 0.68-0.72) and in other Non-Muslim countries (OR = 0.87, 95%CI = 0.86-0.88) had lower odds of participation in breast screening than Australian born women. Women aged 60-64 years (OR = 1.42, 95% CI = 1.40-1.44) had higher odds of participation in the BreastScreen program than 50-54 age group. Conclusion This study provides valuable insights to understanding breast screening participation among women born in Muslim countries residing in Victoria. This population level study contributes to the broader knowledge of screening participation of women born in Muslim

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“…[16][17][18][19] We have previously examined cervical and breast cancer screening for women from Muslim-majority countries, and found differences in screening uptake. 20,21 Considering a higher influx of immigrants from Muslimmajority countries from Asia and from Africa, and the fact that approximately 73% of Canadian Muslims live in Ontario, the main goal of this study was to examine the CRC screening uptake (ie, FOBT modality) and its predictors among immigrant Muslim and non-Muslim majority countries residing in Ontario using country of birth and region of origin as a proxy for religious affiliation. The findings will help to understand the role of religious affiliation in cancer screening uptake.…”

Section: Introductionmentioning

confidence: 99%

Fecal occult blood test screening uptake among immigrants from Muslim majority countries: A retrospective cohort study in Ontario, Canada

et al. 2019

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BackgroundColorectal cancer (CRC) is the second and third highest cause of cancer deaths among Canadian men and women, respectively. Population‐based screening through fecal occult blood testing (FOBT) has been proven to be effective in reducing CRC morbidity and mortality. Although participation in Ontario's organized CRC screening program has been increasing steadily since 2008, its uptake remains low among recent immigrant populations despite the known benefits of screening. To promote participation in CRC screening, it is imperative to understand both individual and system level barriers and enablers. Although a number of immigrant and nonimmigrant factors have been associated with low participation, there is a dearth of knowledge related to the religious affiliation in CRC screening uptake. Our study is among the first to examine this issue in Ontario, one of the most ethnically diverse Canadian provinces and preferred settlement destinations for immigrants.MethodsWe conducted a population‐based retrospective cohort study using linked health care administrative databases. Our cohort included Ontario residents, age 50‐74 who were eligible for FOBT from 1 April 2013 to 31 March 2015.ResultsWe found that immigrants from the Middle East and North Africa and Eastern Europe and Central Asia had the lowest rates of screening. Furthermore, being born in a Muslim‐majority country was associated with lower FOBT screening even after controlling for other confounders including world region and income (ie, overall adjusted relative risk (ARR) of screening 0.92 [95% CI 0.90‐0.93]). Moreover, being enrolled in a primary care model, having a female primary care provider and having an internationally trained physician were associated with increased screening among immigrants from Muslim‐majority countries.ConclusionsThese findings can inform future efforts to improve screening uptake like: enhancing access to primary care providers and enrollment in primary care models, targeted FOBT education for male providers and providers not in a primary care model, development of culturally sensitive and appropriate educational materials, and use of interactive approaches for communication of cancer screening information.

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Cervical Cancer Screening among Women from Muslim-Majority Countries in Ontario, Canada

Cited by 32 publications

References 19 publications

Utilization of cervical cancer screening among migrants and non-migrants in Germany: results from a large-scale population survey

Utilization of cervical cancer screening among migrants and non-migrants in Germany: results from a large-scale population survey

Understanding the participation of breast screening among women born in predominantly Muslim countries living in Victoria, Australia from record-linkage data

Fecal occult blood test screening uptake among immigrants from Muslim majority countries: A retrospective cohort study in Ontario, Canada

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