Cervical cancer screening among urban immigrants by region of origin A population-based cohort study

Objectives We compared the prevalence of appropriate cervical cancer screening among screening-eligible immigrant women from major geographic regions of the world and native-born women Methods We determined the proportion of women who were screened during the three year period of 2006-2008 among 2 9 million screening-eligible women living in urban centres in Ontario Canada In multivariate analyses we adjusted for numerous variables including age neighbourhood-level income and prenatal visits during the study period Results 61 3% of women were up-to date on cervical cancer screening Screening rates were lowest among women from South Asia when compared to the referent group (Canadian-born women and immigrants who arrived before 1985) (adjusted rate ratio 081 95% Cl [0 80-0 82] among women aged 1849 years adjusted rate ratio 0 67 [0 65-0 69] among women aged 50-66 years) Of the older South Asian women living in the lowest-income neighbourhoods and not in a primary care enrolment model 21 9% had been appropriately screened In contrast among Canadian-born women living in the highest-income neighbourhoods and in a primary care enrolment model 790% had been appropriately screened Conclusion Efforts to reduce cervical cancer screening disparities should focus on women living in the lowest-income neighbourhoods and women from South Asia (C) 2010 Elsevier Inc All rights reserved