Uptake of cancer screenings among a multiethnic refugee population in North Texas, 2014-2018.

Amy Raines Milenkov,Martha Felini,Sara Onsa,Holy Chor,Shane Fernando,Rushil Acharya,Elvis Longanga Diese,Eva Baker,Russell Kabir

doi:10.1371/journal.pone.0230675

Amy Raines Milenkov, Martha Felini + Show 7 more

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https://doi.org/10.1371/journal.pone.0230675

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Abstract

BackgroundRefugees are less likely than US born populations to receive cancer screenings. Building Bridges is a community health worker prevention program designed to increase refugee’s cancer screening uptake. The purpose of this cross sectional analysis was to assess differences in uptake of cervical, breast, liver, and colorectal screens across six cultural groups.MethodsData was abstracted in 2018 for this analysis. Participants were categorized into six cultural groups (Myanmar, Central Africa, Bhutan, Somalia, Arabic Speaking Countries, and Other) to assess differences in sociodemographic measures and screening uptake. Uptake proportions were calculated for each cancer type (cervical, breast, liver, and colon) among eligible participants, by gender and cultural group. Differences in uptake across groups were assessed using stratified analysis and logistic regression. Prevalence odds ratios (POR) and 95% confidence intervals (CIs) were calculated for each group to assess the association between screening completion and cultural group.Findings874 refugees were asked about cancer screening history. The majority of participants were either ‘never had been screened’ or ‘not up-to-date’ for every cancer screening. Among age eligible, 82% had no prior pap exam within the past 3 years, 81% had no prior mammogram within the past year, 69% didn’t know their Hepatitis B status and 87% never had a colon cancer screening. Overall, higher uptake of all types of cancer screenings was observed in Myanmar and Bhutanese groups, except colon cancer screening which was higher among Central African Region and Arabic Speaking participants.ConclusionScreening uptake varied by ethnic group and screening type. The program reached an under and never screened population, however, the proportion of refugees who received a cancer screening remained low compared to the US population. Diversity within refugee communities requires adaptation to specific cultural and linguistic needs to include new Americans in cancer elimination efforts.

Highlights

Despite recent changes in refugee resettlement policy, the United States (U.S.) remains the top refugee resettlement country in the world. [1] The U.S has admitted over 3.3 million refugees since 1975. [2] During the 2016 fiscal year alone, 84,995 refugees resettled in the U.S with most arriving from the Democratic Republic of the Congo, Burma, Iraq, and Somalia
The program reached an under and never screened population, the proportion of refugees who received a cancer screening remained low compared to the United States (US) population
These studies, are generally small and without a comparison of screening uptake with other refugee groups. [18,19,20,21]. The purpose of this cross-sectional study was to assess differences in uptake of cervical, breast, liver, and colorectal screens across six immigrant groups participating in the Building Bridges program

Summary

Introduction

Despite recent changes in refugee resettlement policy, the United States (U.S.) remains the top refugee resettlement country in the world. [1] The U.S has admitted over 3.3 million refugees since 1975. [2] During the 2016 fiscal year alone, 84,995 refugees resettled in the U.S with most arriving from the Democratic Republic of the Congo, Burma, Iraq, and Somalia. Refugees face multiple challenges following resettlement in the U.S that may contribute to lower cancer screenings These challenges include language and cultural barriers, fear of procedures, history of trauma, work schedules, childcare commitments, and a lack of understanding the U.S medical infrastructure. [18,19,20,21] The purpose of this cross-sectional study was to assess differences in uptake of cervical, breast, liver, and colorectal screens across six immigrant groups participating in the Building Bridges program. Building Bridges is a community health worker prevention program designed to increase refugee’s cancer screening uptake The purpose of this cross sectional analysis was to assess differences in uptake of cervical, breast, liver, and colorectal screens across six cultural groups.

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