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Journal of Immigrant and Minority Health
Published in: Journal of Immigrant and Minority Health 4/2007

01-10-2007 | Original Paper

Cervical Cancer Screening by Immigrant and Minority Women in Canada

Authors: James Ted McDonald, Steven Kennedy

Published in: Journal of Immigrant and Minority Health | Issue 4/2007

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Abstract

Cervical cancer is one of the most preventable forms of cancer and the Pap smear test is one of the most widely accessible forms of cancer screening. An important public health issue is the extent to which Canadian women are engaging in regular screening for cervical cancer, particularly potentially at-risk groups such as recent immigrants and women from minority ethnic backgrounds. We use recent population health surveys to analyze immigrant and native-born women’s use of Pap smear testing, with a focus on how screening rates differ by ethnic background and characteristics of immigration. We find that almost all recent immigrant women have markedly lower use of Pap smear testing than comparable Canadian-born women, but these rates slowly increase with years in Canada. However, we find wide variation in rates of screening by ethnic background. Screening rates for White immigrant women from countries where the official language is neither English nor French approach Canadian-born women’s utilization rates after 15–20 years in Canada, as do the screening rates of Black and Hispanic women. Screening rates for those from Asian backgrounds remain significantly below native-born Canadian levels even after many years in Canada. As well, immigrant women of Asian background who arrived as children and second-generation Asian Canadians both exhibit significantly lower rates of Pap smear testing than Canadian-born White women.
Footnotes
1
Other recent work on cervical cancer includes Fehringer et al. [25] who study the determinants of Pap testing using administrative data from the Ontario Pap Test Registry. Related work includes Ng et al. [26] who examine mortality from cervical cancer by census metropolitan area using death registration data.
 
2
The Anderson model that expresses help-seeking behavior as a function of predisposing characteristics and enabling resources yields similar predictions about the expected determinants of screening use [32].
 
3
Another reason to pool cross-sectional datasets aside from increasing sample size is that in the absence of a longitudinal dataset with a large immigrant component, pooling independent cross-sections of data is required if arrival period effects and time effects are to be disentangled, a technical point that is discussed below.
 
4
Restricting attention to foreign-born women, the correlation between region of birth and region of origin as indicated by ethnic minority status is generally high. For example, 99% of immigrant women of Southeast Asian ethnicity report being born in one of the Southeast Asian countries, and 89% of Hispanic women report being born in Central or South America. The most dispersed (non-White) ethnic groups are South Asians and Blacks. For foreign-born women of South Asian descent, 67% still report being born in a South Asian country (India, Pakistan, Bangladesh, Sri Lanka). Of the rest, 9% of this group was born in Africa, 6% in South America, 4% in Southeast Asia, with smaller percentages of South Asian women born in other regions of the world. Among foreign-born Blacks, 65% were born in the West Indies while 23% were born in Africa. Of the rest, 6% were born in South America and 3% were born in the UK.
 
5
Other specifications not reported here included additional interactions of survey year with geographic indicators, but no meaningful effect on any of the variables of interest was found. Also, basic specifications with controls for period of arrival but not years in Canada were estimated separately for each survey and the key immigrant and ethnicity terms were comparable.
 
6
Interactions of the language terms (for French and ‘‘other’’ languages) with an indicator for residents of Quebec, the only province of Canada that has French as the official language, were poorly determined and had no significant impact on the other results.
 
7
Due to smaller sample sizes and ease of exposition, we also exclude the arrival cohort terms from the regressions. The inclusion of arrival cohort terms does not significantly affect the main results.
 
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Metadata
Title
Cervical Cancer Screening by Immigrant and Minority Women in Canada
Authors
James Ted McDonald
Steven Kennedy
Publication date
01-10-2007
Publisher
Springer US
Published in
Journal of Immigrant and Minority Health / Issue 4/2007
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI
https://doi.org/10.1007/s10903-007-9046-x

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