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Rates of Cervical Cancer Screening and Dysplasia Among Refugees in a Health Care Safety Net System

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Abstract

Refugees may be at higher risk of cervical dysplasia. The prevalence of screening, pathology, risk factors, and management of patients in our Refugee Women’s Health Clinic (RWHC) was assessed. A retrospective review of RWHC patient records between 2009 and 2015 assessed demographic factors, medical history, initial chief complaint, prevalence of screening, HPV status, and loss to follow-up. We reviewed 696 charts; 84.2% (n = 586) were successfully screened. Prevalence of dysplasia was 6.8% (n = 40). Among those, 5% (n = 2) had high-grade dysplasia, equivalent to 0.34% of the screened population. Only 43.6% received indicated colposcopy. FGM/C was associated with non-statistically significant higher rate of dysplasia, at 11.3%. HIV was associated with a statistically significant higher rate of dysplasia at 36.8% (p < 0.001). The rate of high-grade cervical dysplasia among refugees in RWHC is similar to their home countries. RWHC patients were screened at a higher rate than the general Arizona population.

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Acknowledgements

Special thanks to Jeanne Nizigiyimana and the Refugee Women’s Health Clinic for their assistance and contributions to this study. We would also like to acknowledge the tremendous statistical support provided by Dr. Bikash Bhattarai of Valleywise Health for our data analyses.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Women’s Health, Valleywise Health and District Medical Group, Refugee Women’s Health Clinic, 2601 E Roosevelt, Phoenix, AZ, 85008, USA

    Geetha Fink & Crista E. Johnson-Agbakwu

  2. Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland

    Jasmine Abdulcadir

  3. Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA

    Crista E. Johnson-Agbakwu

  4. Obstetrics & Gynecology, UMass Memorial Health, Worcester, MA, USA

    Crista E. Johnson-Agbakwu

  5. OB Hospitalist Group, Renton, WA, USA

    Geetha Fink

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  1. Geetha Fink
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  3. Crista E. Johnson-Agbakwu
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Correspondence to Crista E. Johnson-Agbakwu.

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Fink, G., Abdulcadir, J. & Johnson-Agbakwu, C.E. Rates of Cervical Cancer Screening and Dysplasia Among Refugees in a Health Care Safety Net System. J Immigrant Minority Health 25, 1315–1322 (2023). https://doi.org/10.1007/s10903-023-01491-4

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