O-GYN-JM-063 Is Immigrant Status Associated with Cervical Cancer Screening Among Women in Canada? Results from a Cross-Sectional Study

Abstract

The objectives included identifying the prevalence of women in Canada who received Pap tests according to the screening guidelines (within the last 3 years), and determining the risk of under-screening for cervical cancer among immigrant women. Women aged 20 to 69 years who completed the Canadian Community Health Survey 2012 were included in this study. The prevalence of screening in the last 3 years among Canadian-born and immigrant women was compared using a chi-square test. A log-binomial model was fit to estimate the relative risk of under-screening for immigrant women while controlling for age, income level, self-identified visible minority, smoking status, and access to a regular physician. A stratified analysis was performed to compare immigrants residing in Canada for greater or less than 10 years. Of the 22,555 women eligible for this study, 75.3% of Canadian-born women and 67.6% of immigrant women reported up-to-date screening (P < 0.001). After adjusting for confounding factors, there was no difference in risk of under-screening between immigrant women and Canadian-born women (RR: 1.07; 95% CI: 0.99–1.15). However, upon stratifying by time since immigration, newer immigrants had a 1.19 (95% CI: 1.09–1.29) times higher risk of being under-screened compared to Canadian-born women. This difference in risk was not seen in long-term immigrants (RR: 1.03; 95% CI: 0.95–1.12). Recent immigration to Canada continues to be associated with a significantly higher risk of under-screening according to Pap guidelines. Social and educational programs targeted towards new immigrants are needed to mitigate the disparity in cervical cancer screening in this high-risk group.