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Participation and Risk of High Grade Cytological Lesions Among Immigrants and Italian-Born Women in an Organized Cervical Cancer Screening Program in Central Italy

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Abstract

Few studies analyzed the risk for high-grade squamous intraepithelial lesions or worse (HSIL+) among immigrants and natives attending organized cervical cancer (CC) screening programs (SP). We evaluated participation and diagnosis of HSIL+ by country of birth with logistic models. Overall 540,779 invitation letters were delivered to target women of Florence SP in three screening rounds (years 2000–2002, 2003–2005, 2006–2008). The probability of attending screening was lower for immigrants than natives, but the difference decreased from 35 % (1st round) to 20 % (2nd–3rd round) for women born in high migration pressure (HMP) countries. The risk of HSIL+ was double than natives for HMP-born women from countries with high prevalence of human papillomavirus, even adjusting for age and previous history of Pap test. This is an important public health problem due to an increasing proportion over time of immigrant women with a lower attendance and greater risk for CC.

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Acknowledgments

We are grateful to Guido Miccinesi for his statistical advice.

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Authors and Affiliations

  1. Clinical and Descriptive Epidemiology Unit, ISPO – Istituto per lo Studio e la Prevenzione Oncologica, Via delle Oblate 2, 50144, Florence, Italy

    Carmen Beatriz Visioli, Emanuele Crocetti & Marco Zappa

  2. Screening Unit, ISPO – Istituto per lo Studio e la Prevenzione Oncologica, Via Cosimo Il Vecchio 2, 50139, Florence, Italy

    Anna Iossa & Karin Louise Andersson

  3. Analytical Cytology and Biomolecular Unit, ISPO – Istituto per lo Studio e la Prevenzione Oncologica, Via Cosimo Il Vecchio 2, 50139, Florence, Italy

    Paolo Bulgaresi

  4. Faculty of Medicine and Surgery, University of Florence, Viale Morgagni, 85, 50134, Florence, Italy

    Antonia Alfieri

  5. ISPO – Istituto per lo Studio e la Prevenzione Oncologica, Via Cosimo Il Vecchio 2, 50139, Florence, Italy

    Gianni Amunni

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  1. Carmen Beatriz Visioli
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  2. Emanuele Crocetti
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Correspondence to Carmen Beatriz Visioli.

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Visioli, C.B., Crocetti, E., Zappa, M. et al. Participation and Risk of High Grade Cytological Lesions Among Immigrants and Italian-Born Women in an Organized Cervical Cancer Screening Program in Central Italy. J Immigrant Minority Health 17, 670–678 (2015). https://doi.org/10.1007/s10903-014-0050-7

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  • DOI: https://doi.org/10.1007/s10903-014-0050-7

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