Migration within Spain, level of education, and cervical cancer screening.

Abstract

Migration has been related to the utilization of preventive care services. We analysed the relation between cervical cancer screening and migration within the same country and socioeconomic status in a context in which there is no organized screening. The health survey of Barcelona (Spain) was the data source. Barcelona, a city in north eastern Spain, has experienced important migration from the south and other regions of Spain. Variables studied were the migrant women's year of arrival, age at arrival, educational attainment and Pap smear test uptake. Multivariate logistic regression analysis was performed to examine the correlations among the variables of interest. Just over 30% of the women had never had a Pap smear test. Uptake was higher among younger, educated women born either in Barcelona or abroad. After adjusting for age, migrant women were at higher risk for not participating in screening tests (odds ratio: 1.23; 1.09-1.39); but after adjusting for educational attainment and age, the odds ratio was no longer significant. This study shows that migrants within Spain have less access to preventive services, such as cervical cancer screening in an opportunistic setting. However, this association is almost completely explained by socioeconomic status. Migration could be seen as a social factor that puts people at risk of falling into lower socioeconomic status associated with poor access to screening.