Inadequacy of cervical cancer screening among urban recent immigrants: A population-based study of physician and laboratory claims in Toronto, Canada

In Canada, Pap smears are recommended from 18 to 69. Self-reported socioeconomic gradients in screening have been documented in North America but there have been few direct measures of Pap smear use among immigrants or socially disadvantaged groups. Our purpose was to investigate whether socioedemog...

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Vydané v:Preventive medicine Ročník 44; číslo 6; s. 536 - 542
Hlavní autori: Lofters, Aisha, Glazier, Richard H., Agha, Mohammad M., Creatore, Maria I., Moineddin, Rahim
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Elsevier Inc 01.06.2007
Predmet:
Administrative data
Adolescent
Adult
Aged
Cervical cancer screening
Communication Barriers
Educational Status
Emigration and Immigration - statistics & numerical data
Female
Health Care Surveys
Humans
Immigration
Insurance Claim Reporting - statistics & numerical data
Internal Medicine
Mass Screening - statistics & numerical data
Middle Aged
Minority Groups
Ontario
Pap smear
Papanicolaou Test
Practice Guidelines as Topic
Quality of Health Care - statistics & numerical data
Registries
Residence Characteristics - statistics & numerical data
Socioeconomic Factors
Socioeconomic status
Urban Health - statistics & numerical data
Uterine Cervical Neoplasms - diagnosis
Vaginal Smears - statistics & numerical data
Women's Health
Ontario
Immigration
Administrative data
Cervical cancer screening
Pap smear
Socioeconomic status
ISSN:0091-7435, 1096-0260
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Popis
Shrnutí:In Canada, Pap smears are recommended from 18 to 69. Self-reported socioeconomic gradients in screening have been documented in North America but there have been few direct measures of Pap smear use among immigrants or socially disadvantaged groups. Our purpose was to investigate whether socioedemographic factors are related to cervical cancer screening in Toronto, Canada. Pap smears were identified using fee and laboratory codes in Ontario physician service claims for 3 years (2000–2002 inclusive) for women aged 18–66. Area-level socioeconomic factors were derived from the 2001 census. At the individual level, recent registrants for health coverage, over 80% of whom are expected to be recent immigrants, were identified as women first registering after January 1, 1993. Among 724,584 women, 55.4% had Pap smears within 3 years. Recent immigration, visible minority, foreign language, low income and low education were all associated with significantly lower area rates. Recent registrants had much lower rates than non-recent registrants (36.9% versus 60.9%). Pap smear rates in Toronto fall below those dictated by evidence-based practice. Recent registrants, a largely immigrant group, have particularly low rates. Efforts to improve coverage need to emphasize women who recently immigrated and those with socioeconomic disadvantage.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0091-7435
1096-0260
DOI:10.1016/j.ypmed.2007.02.019