Department of Family & Community Medicine, University of Toronto, Toronto, Canada.
Prev Med. 2010 Dec;51(6):509-16. doi: 10.1016/j.ypmed.2010.09.014. Epub 2010 Oct 7.
We compared the prevalence of appropriate cervical cancer screening among screening-eligible immigrant women from major geographic regions of the world and native-born women.
We determined the proportion of women who were screened during the three-year period of 2006-2008 among 2.9 million screening-eligible women living in urban centres in Ontario, Canada. In multivariate analyses, we adjusted for numerous variables including age, neighbourhood-level income, and prenatal visits during the study period.
61.3% of women were up-to-date on cervical cancer screening. Screening rates were lowest among women from South Asia when compared to the referent group (Canadian-born women and immigrants who arrived before 1985) (adjusted rate ratio 0.81, 95% CI [0.80-0.82] among women aged 18-49 years, adjusted rate ratio 0.67 [0.65-0.69] among women aged 50-66 years). Of the older South Asian women living in the lowest-income neighbourhoods and not in a primary care enrollment model, 21.9% had been appropriately screened. In contrast, among Canadian-born women living in the highest-income neighbourhoods and in a primary care enrollment model, 79.0% had been appropriately screened.
Efforts to reduce cervical cancer screening disparities should focus on women living in the lowest-income neighbourhoods and women from South Asia.
我们比较了来自世界主要地区的符合筛查条件的移民妇女与本地出生妇女的宫颈癌筛查适宜率。
我们确定了 2006 年至 2008 年期间，居住在加拿大安大略省城市中心的 290 万名符合筛查条件的妇女中，有多少妇女在三年内接受了筛查。在多变量分析中，我们调整了许多变量，包括年龄、社区收入水平和研究期间的产前检查。
61.3%的妇女接受了宫颈癌筛查。与参照组（加拿大出生的妇女和 1985 年前到达的移民）相比，南亚裔妇女的筛查率最低（18-49 岁年龄组调整后的率比为 0.81，95%可信区间[0.80-0.82]；50-66 岁年龄组调整后的率比为 0.67[0.65-0.69]）。在收入最低的社区且未参加初级保健登记模式的老年南亚裔妇女中，有 21.9%接受了适当的筛查。相比之下，在收入最高的社区且参加了初级保健登记模式的加拿大出生妇女中，有 79.0%接受了适当的筛查。
减少宫颈癌筛查差异的努力应侧重于收入最低的社区和南亚裔妇女。
