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

ObjectivesWe compared the prevalence of appropriate cervical cancer screening among screening-eligible immigrant women from major geographic regions of the world and native-born women.MethodsWe 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.Results61.3% 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 0.81, 95% CI [0.80–0.82] among women aged 18–49 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, 79.0% had been appropriately screened.ConclusionEfforts to reduce cervical cancer screening disparities should focus on women living in the lowest-income neighbourhoods and women from South Asia.