Department of Pediatrics & Women's Health, University of North Texas Health Science Center, Fort Worth, TX, United States of America.
Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States of America.
PLoS One. 2020 Mar 30;15(3):e0230675. doi: 10.1371/journal.pone.0230675. eCollection 2020.
Refugees 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.
Data 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.
874 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.
Screening 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.
与美国本土人口相比，难民接受癌症筛查的可能性较低。“搭建桥梁”是一个社区卫生工作者预防项目，旨在提高难民的癌症筛查率。本横断面分析的目的是评估六个文化群体之间在宫颈癌、乳腺癌、肝癌和结直肠癌筛查方面的接受程度差异。
本分析中于 2018 年提取数据。参与者被分为六个文化群体（缅甸、中非、不丹、索马里、讲阿拉伯语国家和其他），以评估社会人口统计学测量和筛查接受程度的差异。在合格参与者中，按性别和文化群体计算每种癌症类型（宫颈癌、乳腺癌、肝癌和结肠癌）的筛查接受率。使用分层分析和逻辑回归评估组间接受率的差异。计算每组筛查完成情况与文化群体之间的关联的比值比（POR）和 95%置信区间（CI）。
874 名难民被问及癌症筛查史。大多数参与者在每种癌症筛查中要么“从未接受过筛查”，要么“未及时接受筛查”。在年龄合格的人群中，82%的人在过去 3 年内没有进行过巴氏涂片检查，81%的人在过去一年中没有进行过乳房 X 光检查，69%的人不知道自己的乙肝状况，87%的人从未进行过结肠癌筛查。总体而言，在缅甸和不丹群体中，所有类型的癌症筛查接受率较高，除了结直肠癌筛查，中非地区和讲阿拉伯语的参与者接受率较高。
筛查接受程度因族裔群体和筛查类型而异。该项目覆盖了未接受过和未筛查过的人群，但与美国人口相比，接受癌症筛查的难民比例仍然较低。难民社区内的多样性需要适应特定的文化和语言需求，以便将新移民纳入癌症消除工作中。
