Department of Medicine, Maine Medical Center, Portland, Maine, USA.
Int J Equity Health. 2009 Aug 14;8:30. doi: 10.1186/1475-9276-8-30.
Minority women, particularly immigrants, have lower cancer screening rates than Caucasian women, but little else is known about cancer screening among immigrant women. Our objective was to assess breast, cervical, and colorectal cancer screening rates among immigrant women from Cambodia, Somalia, and Vietnam and explore screening barriers.
We measured screening rates by systematic chart review (N = 100) and qualitatively explored screening barriers via face-to-face questionnaire (N = 15) of women aged 50-75 from Cambodia, Somalia, and Vietnam attending a general medicine clinic (Portland, Maine, USA).
Chart Review - Somali women were at higher risk of being unscreened for breast, cervical, and colorectal cancer compared with Cambodian and Vietnamese women. A longer period of US residency was associated with being screened for colorectal cancer. We observed a 7% (OR 1.07, 95% CI 1.01-1.13, p = 0.01) increase in the odds that a woman would undergo a fecal occult blood test for each additional year in the US, and a 39% increase in the odds of a woman being screened by colonoscopy or flexible sigmoidoscopy for every five years of additional US residence (OR 1.39, 95% CI 1.21-1.61, p = 0.02). We did not observe statistically significant relationships between odds of being screened by mammography, clinical breast exam or papanicolaou test according to years in the US. Questionnaire - We identified several barriers to breast, cervical, and colorectal cancer screening, including discomfort with exams conducted by male physicians.
Somali women were less likely to be screened for breast, cervical, and colorectal cancer than Cambodian and Vietnamese women in this population, and uptake of colorectal cancer screening is associated with years of residency in this country. Future efforts to improve equity in cancer screening among immigrants may require both provider and community education.
少数民族女性，尤其是移民，癌症筛查率低于白人女性，但对于移民女性的癌症筛查情况知之甚少。我们的目的是评估来自柬埔寨、索马里和越南的移民女性的乳腺癌、宫颈癌和结直肠癌筛查率，并探讨筛查障碍。
我们通过系统的图表审查（N=100）来衡量筛查率，并通过对 15 名年龄在 50-75 岁之间的来自柬埔寨、索马里和越南的女性进行面对面问卷调查，来定性地探讨筛查障碍。这些女性均在缅因州波特兰的一家综合医学诊所就诊。
图表审查 - 与柬埔寨和越南女性相比，索马里女性的乳腺癌、宫颈癌和结直肠癌筛查率较低。在美国的居住时间较长与接受结直肠癌筛查有关。我们观察到，在美国居住的每增加一年，接受粪便潜血试验的可能性增加 7%（OR 1.07，95%CI 1.01-1.13，p=0.01），而每增加五年在美国居住，接受结肠镜或乙状结肠镜检查的可能性增加 39%（OR 1.39，95%CI 1.21-1.61，p=0.02）。我们没有观察到与在美国的居住年限相关的接受乳房 X 线照相术、临床乳房检查或巴氏试验的可能性有统计学意义的关系。问卷调查 - 我们确定了乳腺癌、宫颈癌和结直肠癌筛查的几个障碍，包括对男医生进行的检查感到不适。
在该人群中，与柬埔寨和越南女性相比，索马里女性接受乳腺癌、宫颈癌和结直肠癌筛查的可能性较低，而结直肠癌筛查的接受程度与在美国的居住年限有关。未来为改善移民的癌症筛查公平性，可能需要对提供者和社区进行教育。
