Breast cancer screening utilization among women from Muslim majority countries in Ontario, Canada

Breast cancer incidence by country of birth among immigrant women in British Columbia, Canada.

AIM
The aim of this study was to summarize the latest research reports about immigrant women and attendance in breast cancer screening.


DESIGN
Scoping review.


METHODS
Literature searches were made in CINAHL, PubMed, Web of Science, Google Scholar, Oatd and Oalster. Twenty-three articles were included in the study. Data were analysed with inductive content analysis.


RESULTS
Out of data four main categories were formed: attendance rates, incidence, barriers and facilitators, and knowledge and perception. The results show that attendance rates, barriers and facilitators for attendance, knowledge and experience of breast cancer and breast cancer screening differ between several factors such as the woman's migrant background, country of origin, religion, length of stay in the new home country and sociodemographic factors.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/nop2.1865

Breast cancer screening and immigrant women-A scoping review of attendance, knowledge, barriers and facilitators.

Several studies have shown that attendance rates are lower among non-Western immigrants than among natives. As the Nordic countries have quite similar health systems and populations but also differences in the organisation of their organised mammography screening programmes, differences in attendance rates could highlight organisational factors that might increase the attendance rates. Mammography screening is offered free of charge in Denmark and Finland, but not in Iceland and Norway. Contrarily to the other countries, Iceland do not send out pre-booked appointment. The study population included natives and non-Western immigrants aged 50-69 years, who had at least one invitation to the national mammography screening programmes in Denmark (2008-2017), Finland (2001-2017), Iceland (2001-2020) or Norway (2001-2015). Relative risks (RRs) of attendance were estimated and adjusted for age group and calendar period. The study population included 116.033 non-Western immigrants and more than 2 million natives. The attendance rates were significantly lower among non-Western immigrants than among natives, with an adjusted relative risk of 0.81/0.80 in Denmark and Finland, 0.62 in Norway, and 0.40 in Iceland. The lower attendance rates among immigrants in Norway and Iceland did not seem to be due to differences in birth country, immigration age, or educational level, but might be explained by organisational factors. Offering free-of-charge mammography screening in Norway and Iceland and/or including a pre-booked appointment in the invitation letters in Iceland might increase the attendance rate among non-Western immigrants. 

Differences in mammography screening attendance among non-Western immigrants in Denmark, Finland, Iceland and Norway

Research suggests that factors beyond the individual level, such as neighborhood-level factors, warrant further investigation in explaining preventive screening utilization disparities. In addition, research shows that immigrant women, especially recent immigrants, are less likely than U.S.-born women to utilize preventive screenings. Our study examined the relationship between perceived neighborhood social cohesion and breast and cervical cancer screening utilization among U.S.-born and immigrant women. Data came from the 2018 National Health Interview Survey (NHIS). The sample for this study included 7801 women ages 21−64 without a hysterectomy. Of them, 1477 (19%) reported being born outside the United States. Logistic regression was used to examine associations of perceived neighborhood social cohesion and sociodemographic factors with the odds of screening by nativity status. Though we found no link between neighborhood social cohesion and Papanicolaou (Pap) test or mammogram utilization, our findings contribute to understanding sociodemographic barriers to and facilitators of preventive screening utilization among immigrant and U.S.-born women. Most importantly, racial/ethnic and socioeconomic disparities in Pap tests and mammogram utilization were evident among immigrant women. The disparities we identified indicate the need to target prevention messages and tailor interventions to address each group's sociodemographic characteristics and needs. Our findings also support the need to expand health insurance so that all women are covered.

https://doi.org/10.3934/publichealth.2022039

Perceived neighborhood social cohesion and cervical and breast cancer screening utilization among U.S.-born and immigrant women

Breast cancer screening programs operate across Canada providing mammography to women in target age groups with the goal of reducing breast cancer mortality through early detection of tumors. Disparities in breast screening participation among socio-demographic groups, including immigrants, have been reported in Canada. Our objectives were to: (1) assess breast screening participation and retention among immigrant and nonimmigrant women in British Columbia (BC), Canada; and (2) to characterize factors associated with screening among screening-age recent immigrant women in BC. We examined 2 population-based cohorts of women eligible for breast screening participation (537 783 women) and retention (281 052 women) using linked health and immigration data. Breast screening rates were presented according to socio-demographic and health-related variables stratified by birth country. Factors associated with screening among recent immigrant women were explored using Poisson regression. We observed marked variation in screening participation across birth country cohorts. Eastern European/Central Asian women showed low participation (37.9%) with rates from individual countries ranging from 35.0% to 49.0%. Participation rates for immigrant women from the most common birth countries, such as China/Macau/Hong Kong/Taiwan (45.7%), India (44.5%), the Philippines (45.9%), and South Korea (39.0%), were lower than the nonimmigrant rates (51.2%). Retention rates showed less variation by birth country; however, some disparities between immigrant and nonimmigrant groups persisted. Associations between screening indicators and study factors varied considerably across immigrant groups. Primary care physician visits were consistently positively associated with screening participation; this variable was also the only predictor associated with screening within each of the groups of recent immigrants. Our study provides unique data on both screening participation and retention among Canadian immigrant women compiled by individual country of birth. Our results are further demonstration that screening disparities exist among immigrant populations as well as in comparison with nonimmigrant women.

Breast screening participation and retention among immigrants and nonimmigrants in British Columbia: A population-based study.

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Breast screening participation and retention among immigrants and nonimmigrants in British Columbia: A population-based study.