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Factors Associated with Underscreening for Cervical Cancer among Women in Canada

  • Schoueri-Mychasiw, Nour (School of Public Health and Health Systems, AHS, University of Waterloo) ;
  • McDonald, Paul Wesley (College of Health, Massey University Albany)
  • Published : 2013.11.30

Abstract

Background: Cervical cancer is the second most common cancer among women worldwide. Failure to prevent cervical cancer is partly due to non-participation in regular screening. It is important to plan and develop screening programs directed towards underscreened women. In order to identify the factors associated with underscreening for cervical cancer among women, this study examined Pap test participation and factors associated with not having a time-appropriate (within 3 years) Pap test among a representative sample of women in Ontario, Canada using Canadian Community Health Survey (CCHS) data. Materials and Methods: Univariate analyses, cross-tabulations, and logistic regression modeling were conducted using cross-sectional data from the 2007-2008 CCHS. Analyses were restricted to 13,549 sexually active women aged 18-69 years old living in Ontario, with no history of hysterectomy. Results: Almost 17% of women reported they had not had a time-appropriate Pap test. Not having a time-appropriate Pap test was associated with being 40-69 years old, single, having low education and income, not having a regular doctor, being of Asian (Chinese, South Asian, other Asian) cultural background, less than excellent health, and being a recent immigrant. Conclusions: Results indicate that disparities still exist in terms of who is participating in cervical cancer screening. It is crucial to develop and implement cervical cancer screening programs that not only target the general population, but also those who are less likely to obtain a Pap tests.

Keywords

Pap tests;cervical cancer screening;women's health;participation factors;Canada

References

  1. Ahmad F, Cameron JI, Stewart DE (2005). A tailored intervention to promote breast cancer screening among South Asian immigrant women. Soc Sci Med, 60, 575-86. https://doi.org/10.1016/j.socscimed.2004.05.018
  2. Akers AY, Newmann SJ, Smith JS (2007). Factors underlying disparities in cervical cancer incidence, screening, and treatment in the United States. Curr Probl Cancer, 31, 157-81. https://doi.org/10.1016/j.currproblcancer.2007.01.001
  3. Amankwah E, Ngwakongnwi E, Quan H (2009). Why many visible minority women in Canada do not participate in cervical cancer screening. Ethn Health, 14, 337-49. https://doi.org/10.1080/13557850802699122
  4. Branoff R, Santi K, Campbell JK, et al (1997). A family practice residency cervical screening project: perceived screening barriers. Fam Med, 29, 119-23.
  5. Brooks SE, Hembree TM, Shelton BJ, et al (2013). Mobile mammography in underserved populations: analysis of outcomes of 3,923 women. J Community Health, 38, 900-6. https://doi.org/10.1007/s10900-013-9696-7
  6. Demirtas B, Acikgoz I (2013). Promoting attendance at cervical cancer screening: understanding the relationship with Turkish womens’ health beliefs. Asian Pac J Cancer Prev, 14, 333-40. https://doi.org/10.7314/APJCP.2013.14.1.333
  7. Fowler N (1998). Providing primary health care to immigrants and refugees: the North hamilton experience. CMAJ, 159, 388-91.
  8. Garces-Palacio IC, Scarinci IC (2012). Factors associated with perceived susceptibility to cervical cancer among Latina immigrants in Alabama. Matern Child Health J, 16, 242-8. https://doi.org/10.1007/s10995-010-0737-x
  9. George U, Ramkissoon S (1998). Race, gender, and class: Interlocking oppressions in the lives of South Asian women in Canada. Affilia, 13, 102-19. https://doi.org/10.1177/088610999801300106
  10. Hislop TG, Teh C, Lai A, et al (2000). Cervical cancer screening in BC Chinese women. BCMJ, 42, 456-60.
  11. Kaida A, Colman I, Janssen PA (2008). Recent Pap tests among Canadian women: Is depression a barrier to cervical cancer screening? J Womens Health, 17, 1175-81. https://doi.org/10.1089/jwh.2007.0626
  12. Katz MH (1999). Multivariable analysis: A practical guide for clinicians. Cambridge: Cambridge University Press.
  13. Latif E (2010). Recent immigrants and the use of cervical cancer screening test in Canada. J Immigr Minor Health, 12, 1-17. https://doi.org/10.1007/s10903-009-9237-8
  14. Lee J, Parsons GF, Gentleman JF (1998). Falling short of Pap test guidelines. Health Rep, 10, 9-19.
  15. Lofters AK, Glazier RH, Agha MM, et al (2007). Inadequacy of cervical cancer screening among urban recent immigrants: A population-based study of physician and laboratory claims in Toronto, Canada. Prev Med, 44, 536-42. https://doi.org/10.1016/j.ypmed.2007.02.019
  16. Lofters AK, Hwang SW, Moineddin R, et al (2010). Cervical cancer screening among urban immigrants by region of origin: a population-based cohort study. Prev Med, 51, 509-16. https://doi.org/10.1016/j.ypmed.2010.09.014
  17. Lopez-de-Andres A, Martin-Lopez R, Hernandez-Barrera V, et al (2010). Predictors of breast and cervical cancer screening in a Spanish metropolitan area. J Womens Health, 19, 1675-81. https://doi.org/10.1089/jwh.2009.1828
  18. Lynch FL, Whitlock EP, Valanis BG, et al (2004). Cost-effectiveness of a tailored intervention to increase screening in HMO women overdue for Pap test and mammography services. Prev Med, 38, 403-11. https://doi.org/10.1016/j.ypmed.2003.11.024
  19. McDonald JT, Kennedy S (2007). Cervical cancer screening by immigrant and minority women in Canada. J Immigr Minor Health, 9, 323-34. https://doi.org/10.1007/s10903-007-9046-x
  20. McDonald JT, Trenholm R (2010). Cancer-related health behaviours and health service use among Inuit and other residents of Canada’s north. Soc Sci Med, 70, 1396-403. https://doi.org/10.1016/j.socscimed.2010.01.008
  21. Olesen SC, Butterworth P, Jacomb P, et al (2012). Personal factors influence use of cervical cancer screening services: Epidemiological survey and linked administrative data address the limitations of previous research. BMC Health Serv Res, 12, 34. https://doi.org/10.1186/1472-6963-12-34
  22. Pauly BB, Macdonald M, Hancock T, et al (2013). Reducing health inequities: the contribution of core public health services in BC. BMC Public Health, 13, 550. https://doi.org/10.1186/1471-2458-13-550
  23. Percac-Lima S, Ashburner JM, Bond B, et al (2013). Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation. J Gen Intern Med, 28, 1463-8. https://doi.org/10.1007/s11606-013-2491-4
  24. Peto J, Gilham C, Fletcher O, et al (2004). The cervical cancer epidemic that screening has prevented in the UK. Lancet, 364, 249-56. https://doi.org/10.1016/S0140-6736(04)16674-9
  25. Rodvall Y, Kemetli L, Tishelman C, et al (2005). Factors related to participation in a cervical cancer screening programme in urban Sweden. Eur J Cancer Prev, 14, 459-66. https://doi.org/10.1097/01.cej.0000178078.21910.da
  26. Schoueri-Mychasiw N, Campbell S, Mai V (2013). Increasing screening mammography among immigrant and minority women in Canada: A review of past interventions. J Immigr Minor Health, 15, 149-58. https://doi.org/10.1007/s10903-012-9612-8
  27. Schroeder MA (1990). Diagnosing and dealing with multicollinearity. West J Nurs Res, 12, 175-87. https://doi.org/10.1177/019394599001200204
  28. Shields M, Wilkins K (2009). An update on mammography use in Canada. Health Rep, 20, 7-19.
  29. Tudiver F, Guibert R, Haggerty J, et al (2002). What influences family physicians’ cancer screening decisions when practice guidelines are unclear or conflicting? J Fam Pract, 51, 760.
  30. Ukoli FA, Patel K, Hargreaves M, et al (2013). A tailored prostate cancer education intervention for low-income African Americans: Impact on knowledge and screening. J Health Care Poor Underserved, 24, 311-31. https://doi.org/10.1353/hpu.2013.0033
  31. Van Til L, MacQuarrie C, Herbert R (2003). Understanding the barriers to cervical cancer screening among older women. Qual Health Res, 13, 1116-31. https://doi.org/10.1177/1049732303255975
  32. Weerasinghe S, Mitchell T, Hamilton L, et al (2000). Equitable access to health care, health promotion, and disease prevention for recent immigrant women living in Nova Scotia, Canada: Report on phase 1, fact sheet. Halifax: Maritime Centre of Excellence for Women's Health.
  33. Xiong H, Murphy M, Mathews M, et al (2010). Cervical cancer screening among Asian Canadian immigrant and nonimmigrant women. Am J Health Behav, 34, 131-43.
  34. Young T K, McNicol P, Beauvais J (1997). Factors associated with human papillomavirus infection detected by polymerase chain reaction among urban Canadian aboriginal and non-aboriginal women. Sex Transm Dis, 24, 293-8. https://doi.org/10.1097/00007435-199705000-00011

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