Cancer Screening among immigrants living in urban and regional Australia: results from the 45 and up study.

Marianne F Weber,Clare Kahn,Freddy Sitas,May Chiew,Lucy Webster,Eleonora Feletto

doi:10.3390/ijerph110808251

Abstract

Over 25% of the Australian population are immigrants, and are less active participants in cancer screening programmes. Most immigrants live in urban areas of Australia, but a significant proportion (~20%), live in regional areas. This study explored differences in cancer screening participation by place of birth and residence. Self-reported use of mammogram, faecal occult blood test (FOBT), and/or prostate specific antigen (PSA) tests was obtained from 48,642 immigrants and 141,275 Australian-born participants aged 50 years or older in the 45 and Up Study (New South Wales, Australia 2006–2010). Poisson regression was used to estimate relative risks of test use, adjusting for key socio-demographic characteristics. Overall, immigrants from Asia and Europe were less likely to have had any of the tests in the previous two years than Australian-born participants. Regional Australian-born participants were more likely to have had any of the tests than those living in urban areas. Regional immigrant participants were more likely to have had an FOBT or PSA test than those living in urban areas, but there were no differences in mammograms. This report identifies key immigrant groups in urban and regional areas that policymakers and healthcare providers should target with culturally appropriate information to promote cancer screening

Highlights

Australia is a culturally diverse and geographically vast nation, with over a quarter of the population born overseas [1] and nearly one third of the population living outside the main urban centres [2]
Of the 189,917 included participants, 45.1% lived in an urban area and 54.9% lived in a regional area
Immigrants living in regional areas were slightly (6%) more likely to have had a prostate specific antigen (PSA) test than urban immigrants, but there was no difference in mammogram uptake by place of residence. To explore these differences further, we analysed cancer screening uptake by place of birth for urban and regional areas separately (Figures 1 and 2). In both urban and regional areas, immigrants had lower faecal occult blood test (FOBT) use in the previous two years than those born in Australia

Summary

Introduction

Australia is a culturally diverse and geographically vast nation, with over a quarter of the population born overseas [1] and nearly one third of the population living outside the main urban centres [2]. Screening programmes are key initiatives for early detection of cancer and Australia has organised national screening programmes for bowel, breast, and cervical cancer [5,6,7] as well as high rates of opportunistic prostate-specific antigen (PSA) testing for prostate cancer [8]. Cancer screening can be controversial, with the number of lives saved through early diagnosis weighed against potential over-diagnosis and over-treatment of indolent tumours [9]. In the case of prostate cancer, contradictory evidence from large trials renders the continuing widespread use of PSA testing complex [10]. Reductions in mortality rates have been proven for breast, cervical, bowel, and prostate cancer screening [11,12,13,14]

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Conclusion