Inequalities in cervical cancer screening utilisation and results: A comparison between Italian natives and immigrants from disadvantaged countries

Federica Gallo, Adele Caprioglio, Roberta Castagno, Guglielmo Ronco, Nereo Segnan and Livia Giordano

Health Policy, 2017, vol. 121, issue 10, 1072-1078

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.

Keywords: Immigrants; Mass screening; Cervical cancer; Demographic factors; Screening outcomes (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (4)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:121:y:2017:i:10:p:1072-1078

DOI: 10.1016/j.healthpol.2017.08.005

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