Cervical Cancer Awareness and Screening Practises Amongst Migrant Women Living in Sydney

Abstract

Cervical cancer is the 4^th most prevalent cancer among women worldwide. The incidence rate of cervical cancer is low in Australia. Despite the use of vaccinations and cervical screening programs in Australia, migrant women living in Sydney still face significant health disparities when accessing cervical cancer screening services. Overall, there are limited studies that explore the barriers and facilitators that migrant women are exposed to when accessing cervical screening tests. The aim of this study is to describe the attitudes, beliefs, knowledge and awareness of cervical cancer screening and screening practices amongst migrant women aged 25 and above living in Sydney, Australia for more than one year with no history of cervical cancer. Fifty-two women (30 South-East Asian, 12 Middle Eastern & 10 African) were recruited using two non-probabilistic sampling methods, convenience and snowball sampling. Data was collected through Focus Group Discussions (FGDs). In total, 5 FGDs were conducted in homogenous groups of 8-12 participants. Each FGD was audio-recorded and verbatim transcribed. The data were analysed using thematic analysis. Results show that average age of the participants were 38 years, majority were from South East Asia (58%), married (87%), unemployed (65%), had tertiary education (67%), were in low income categories (84%), and a third (35%) living in Australia for < 5 years. Results further show that migrant women living in Sydney displayed a lack of awareness and knowledge about cervical cancer and screening practices. Individual and system-level barriers and facilitators that influenced screening attendance were identified. Factors such as lack of knowledge, emotional barriers, cultural and religious barriers, psychological barriers, and organisational factors influence screening practices. Furthermore, results also revealed that African migrants were less likely to be aware of cervical cancer and screening compared to South-East Asian and Middle Eastern women. Our study also reported that short-term migrants had an overall lack of awareness about cervical screening and therefore, differences in migration status must be considered when administering health education programs. Understanding migrant women’s experiences, facilitators, and barriers to accessing cervical screening is essential in assisting health care professionals and policy makers to provide culturally appropriate services. Provision of training or programs to increase culturally appropriate health services amongst health care providers is also recommended. To increase cervical cancer screening uptake of migrant women living in Sydney, culturally appropriate education programs and health promotion strategies targeted towards different ethnic groups need to be administered.