Inequalities in cervical cancer screening utilisation and results: A comparison between Italian natives and immigrants from disadvantaged countries. Issue 10 (October 2017)

• Record Type: Journal Article
• Authors: Gallo, Federica; Caprioglio, Adele; Castagno, Roberta; Ronco, Guglielmo; Segnan, Nereo; Giordano, Livia
• Is Part Of: Health policy. Volume 121:Issue 10(2017)
• Page Start: 1072
• Page End: 1078
• Publication Date: 2017-10
• Subjects: Immigrants -- Mass screening -- Cervical cancer -- Demographic factors -- Screening outcomes; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2017.08.005
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Cervical screening underutilisation is well documented among immigrants from poor countries. Participation rate to cervical screening was lower for immigrants than for Italians. Increasing age, illiteracy, being single, negatively influenced immigrants' participation. Severe lesions nearly double among immigrants in first screens compared to Italians. Policy makers should support screening providers in establishing coalitions with immigrants' organisations. Abstract: Cervical cancer screening underutilisation is documented among immigrants from poor countries and it is associated to an augmented risk for severe lesions. In a cohort of 1, 410, 364 Italian women and 200, 491 immigrants from poor countries differences in screening participation and results were investigated. Participation rate was lower for immigrants than for Italians: 43.98% versus 48.59% (chi(1): p < 0.001). This gap increased with age (ptrend < 0.0001). Some socio-demographic factors negatively influenced immigrants' participation. Illiteracy (OR = 0.75) versus secondary school, being single (OR = 0.71) versus attached, first screens (OR = 0.67) versus subsequent ones. Although the interaction between educational and professional levels showed that graduated immigrant women conducting an intellectual job have a higher inclination towards screening than their Italian peers (OR = 1.43 vs OR = 1.04). The Standardised Detection Ratio (SDR) suggested a frequency of severe lesions nearly double among immigrants in first screens (SDR = 1.94; 95% CI: 1.82–2.08) and even higher (SDR = 2.53; 95% CI: 2.35–2.73) for Central/Eastern Europeans. Multi-component interventions involving both patients and providers offer the greatest potential to increase cervical cancer screening uptake within foreign-born populations. So immigrant-specific interventions are needed for some immigrant groups, like Central/Eastern Europeans who are at higher risk of cervical lesions and, together with Asians and Africans, showed a poor attitude towards cancer prevention.