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Cervical cancer screening in immigrant populations in British Columbia : participation rates and sociodemographic characteristics of use Fletcher, Jennifer Lee


Background: The Pap screening practices of British Columbia's immigrant population and the specific barriers they face in accessing cervical cancer screening services are not well understood. This study attempts to gain a broad understanding of patterns in immigrant women's use of Pap screening programs, exploring rates of Pap screening participation, sociodemographic correlates of use and reported barriers to access for immigrant women in the BC relative to those of native-born Canadians in the province. Methods: Self-reported data on use of Pap screening services, immigration status and sociodemographic information were obtained from the Canadian Community Health Survey Cycle 3.1 for female respondents 18 to 69 years of age living in British Columbia. Lifetime and three-year Pap screening participation rates were calculated and multivariate logistic regression methods used to model the relationship between Pap screening participation and sociodemographic variables thought to be potential correlates of screening. Subgroup analyses of screening participation based on the racial or ethnic origin and country of birth of immigrant women were also conducted. Results: Immigrant women were found to participate in Pap screening, both over the lifetime and within the last three years, at rates significantly lower than those of non-immigrant women. Only 79% of immigrant women report having had a Pap test during their lifetime, compared to 93% of non-immigrant women. Those figures drop to 66% of immigrant women and 78% of non-immigrant women for Pap screens within the last three years. Many of the sociodemographic correlates of use are similar in the immigrant and non-immigrant populations, but often with different impacts on screening participation between the two groups. East Asian and South Asian immigrant women in particular report rates of screening participation below those of non-immigrant women, while participation rates among European immigrants are comparable to those of native-born Canadians. Conclusions: Subgroups of immigrant women in British Columbia are currently under-served by existing Pap screening programs in the province. Culturally-appropriate programs and policies are required to improve screening participation in these groups, thereby helping to decrease the cervical cancer burden presently being borne by these populations.

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