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Canadian Journal of Public Health

, Volume 98, Issue 6, pp 470–475 | Cite as

Immigrant Women and Cervical Cancer Screening Uptake

A Multilevel Analysis
  • Kelly J. WoltmanEmail author
  • K. Bruce Newbold
Article
  • 1 Downloads

Abstract

Background

Contextual factors may play an influential role in determining individual uptake of preventive health care services, especially among potentially vulnerable subpopulations. Using cervical cancer screening as a case study, this paper examines the multilevel factors associated with Pap testing in native-born and immigrant women.

Methods

Cross-sectional multilevel logistic regression models were used to identify the individual- and neighbourhood-level characteristics that might explain differences in the lifetime uptake of Pap testing among immigrants and native-born women between the ages of 18 and 69 residing in the Montreal, Toronto and Vancouver Census Metropolitan Areas (CMAs). Individual-level data were drawn from the Canadian Community Health Survey (Cycle 2.1, 2003) and linked with census tract profile data from the Canadian Census (2001).

Results

Findings reveal significant between-neighbourhood variation in uptake. After controlling for age, marital status, access to a regular doctor and socio-economic status, a woman’s immigrant status and cultural origin appear to be significantly associated with ever having had a Pap test. In particular, the uptake of cervical cancer screening is less common among recent immigrant women and women of Chinese, South Asian and other Asian backgrounds.

Interpretation

There appear to be significant differences between neighbourhoods and CMAs in the uptake of Pap testing. Findings point to the role of cultural origin, which largely accounts for these differences. This indicates the need to promote greater information and awareness of public health services for cervical cancer screening, especially among recent immigrant women with such backgrounds.

MeSH terms

Women’s health environment, preventive medicine and public health Papanicolaou smear immigrants cross-sectional studies 

Résumé

Contexte

Des facteurs contextuels pourraient influencer l’utilisation individuelle des services de santé préventifs, surtout dans les sous-populations potentiellement vulnérables. Notre analyse, réalisée à partir du cas exemplaire du dépistage du cancer du col utérin, porte sur les facteurs multiniveaux associés à l’utilisation du test de Papanicolaou par les Canadiennes de naissance et les immigrantes.

Résultats

x: Au moyen de modèles de régression logistique transversaux et multiniveaux, nous avons repéré les caractéristiques individuelles et par quartier pouvant expliquer les écarts dans l’utilisation, au cours de la vie, du test de Papanicolaou par les Canadiennes de naissance et les immigrantes de 18 à 69 ans vivant dans les régions métropolitaines de recensement (RMR) de Montréal, Toronto et Vancouver. Les données individuelles provenaient de l’Enquête sur la santé dans les collectivités canadiennes (cycle 2.1, 2003); nous les avons liées aux données descriptives générales par secteur de recensement publiées dans le Recensement du Canada (2001).

Résultats

Nous avons observé des écarts significatifs dans l’utilisation du test de Papanicolaou selon le quartier. Compte tenu de l’âge, de l’état matrimonial, de l’accès à un médecin de famille et du statut socioéconomique, le statut d’immigrante et l’origine culturelle semblent présenter une corrélation significative avec le fait d’avoir subi au moins un test de Papanicolaou. L’utilisation du test est moins courante chez les immigrantes récentes et chez les femmes originaires de la Chine, de l’Asie du Sud et d’autres parties de l’Asie.

Interprétation

Il semble exister des écarts significatifs d’un quartier et d’une RMR à l’autre dans l’utilisation du test de Papanicolaou. La plupart s’expliquent par l’origine culturelle. Il faudrait sans doute promouvoir une information et une sensibilisation plus complètes des services de dépistage du cancer du col utérin, surtout auprès des immigrantes récentes d’origine asiatique.

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Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  1. 1.School of Geography and Earth SciencesMcMaster UniversityHamiltonCanada

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