“…Cultural values, beliefs about sexual behaviour, language barriers, fatalism, acculturation, and lack of knowledge about cca influence the use of Pap screening by immigrants [15][16][17][18] . The cca risk among immigrants appears to be lower with length of time lived in Canada, which might be attributable to a greater likelihood of screening use in long-term immigrants than in recent immigrants 9,19,20 . Language barriers 10 and lower education level 10,12,21 are associated with greater risk of cca, likely because of poor use of Pap screening 9,10,20,22,23 .…”