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Inequalities in cervical cancer screening utilisation and results: A comparison between Italian natives and immigrants from disadvantaged countries

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  • Gallo, Federica
  • Caprioglio, Adele
  • Castagno, Roberta
  • Ronco, Guglielmo
  • Segnan, Nereo
  • Giordano, Livia

Abstract

Cervical cancer screening underutilisation is documented among immigrants from poor countries and it is associated to an augmented risk for severe lesions. In a cohort of 1,410,364 Italian women and 200,491 immigrants from poor countries differences in screening participation and results were investigated. Participation rate was lower for immigrants than for Italians: 43.98% versus 48.59% (chi(1): p<0.001). This gap increased with age (ptrend<0.0001). Some socio-demographic factors negatively influenced immigrants' participation. Illiteracy (OR=0.75) versus secondary school, being single (OR=0.71) versus attached, first screens (OR=0.67) versus subsequent ones. Although the interaction between educational and professional levels showed that graduated immigrant women conducting an intellectual job have a higher inclination towards screening than their Italian peers (OR=1.43 vs OR=1.04). The Standardised Detection Ratio (SDR) suggested a frequency of severe lesions nearly double among immigrants in first screens (SDR=1.94; 95% CI: 1.82–2.08) and even higher (SDR=2.53; 95% CI: 2.35–2.73) for Central/Eastern Europeans. Multi-component interventions involving both patients and providers offer the greatest potential to increase cervical cancer screening uptake within foreign-born populations. So immigrant-specific interventions are needed for some immigrant groups, like Central/Eastern Europeans who are at higher risk of cervical lesions and, together with Asians and Africans, showed a poor attitude towards cancer prevention.

Suggested Citation

  • Gallo, Federica & Caprioglio, Adele & Castagno, Roberta & Ronco, Guglielmo & Segnan, Nereo & Giordano, Livia, 2017. "Inequalities in cervical cancer screening utilisation and results: A comparison between Italian natives and immigrants from disadvantaged countries," Health Policy, Elsevier, vol. 121(10), pages 1072-1078.
    • Handle: RePEc:eee:hepoli:v:121:y:2017:i:10:p:1072-1078
    DOI: 10.1016/j.healthpol.2017.08.005
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    1. Walsh, Brendan & Silles, Mary & O'Neill, Ciarán, 2011. "The importance of socio-economic variables in cancer screening participation: A comparison between population-based and opportunistic screening in the EU-15," Health Policy, Elsevier, vol. 101(3), pages 269-276, August.
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    1. Isabella Rosato & Teresa Dalla Zuanna & Valentina Tricarico & Claudio Barbiellini Amidei & Cristina Canova, 2023. "Adherence to Cervical Cancer Screening Programs in Migrant Populations: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 20(3), pages 1-14, January.
    2. Esther E. Idehen & Anna-Maija Pietilä & Mari Kangasniemi, 2020. "Barriers and Facilitators to Cervical Screening among Migrant Women of African Origin: A Qualitative Study in Finland," IJERPH, MDPI, vol. 17(20), pages 1-20, October.
    3. Esther E. Idehen & Anni Virtanen & Eero Lilja & Tomi-Pekka Tuomainen & Tellervo Korhonen & Päivikki Koponen, 2020. "Cervical Cancer Screening Participation among Women of Russian, Somali, and Kurdish Origin Compared with the General Finnish Population: A Register-Based Study," IJERPH, MDPI, vol. 17(21), pages 1-16, October.
    4. Patrícia Marques & Ana Gama & Mário Santos & Bruno Heleno & Heleen Vermandere & Sónia Dias, 2021. "Understanding Cervical Cancer Screening Barriers among Migrant Women: A Qualitative Study with Healthcare and Community Workers in Portugal," IJERPH, MDPI, vol. 18(14), pages 1-13, July.

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