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Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Factors associated with cervical cancer screening uptake among Inuit women in Nunavik, Quebec, Canada

Authors: Helen Cerigo, Francois Coutlée, Eduardo L Franco, Paul Brassard

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

The Canadian circumpolar Inuit population has a higher incidence rate of cervical cancer than the general population and the majority of cases occur among underscreened women. The objectives of this study were to determine Pap smear utilization rates and to determine factors associated with time-inappropriate use of cervical cancer screening among a cohort of Inuit women from Nunavik, Quebec, Canada.

Methods

This study utilizes baseline information collected from a cohort formed between January 2002 and December 2007 to study the natural history of HPV among Inuit women aged 21–69 years in Nunavik, Quebec. Cervical cancer screening history and other variables were obtained from a baseline questionnaire and medical chart review. Unconditional logistic regression was used to estimate the odds ratios and 95% confidence intervals for potential predictors of not having a Pap smear within the previous 3 years prior to cohort entry.

Results

A total of 403 Inuit women who had a baseline questionnaire and chart review were included. The mean age of the study population was 34.2 years. In the three years prior to study entry, 25% of women did not have a Pap smear. Older age and never giving birth were significant predictors of time-inappropriate Pap smear use.

Conclusions

Our results suggest that older women and women who are not accessing reproductive care have a lower compliance with time-appropriate cervical cancer screening and future research should address potential strategies to increase screening coverage among this group.
Literature
1.
go back to reference Health Canada: Cervical Cancer Screening in Canada: 1998 Surveillance Report; Cat. No. H439-616/1998E. 2002, Canada: Ministry of Public Works and Government Services Health Canada: Cervical Cancer Screening in Canada: 1998 Surveillance Report; Cat. No. H439-616/1998E. 2002, Canada: Ministry of Public Works and Government Services
2.
go back to reference Spence AR, Goggin P, Franco EL: Process of care failures in invasive cervical cancer: systematic review and meta-analysis. Prev Med. 2007, 45: 93-106. 10.1016/j.ypmed.2007.06.007.CrossRefPubMed Spence AR, Goggin P, Franco EL: Process of care failures in invasive cervical cancer: systematic review and meta-analysis. Prev Med. 2007, 45: 93-106. 10.1016/j.ypmed.2007.06.007.CrossRefPubMed
3.
go back to reference Blackwell DL, Martinez ME, Gentleman JF: Women’s compliance with public health guidelines for mammograms and pap tests in Canada and the United States: an analysis of data from the Joint Canada/United States Survey Of Health. Womens Health Issues. 2008, 18: 85-99. 10.1016/j.whi.2007.10.006.CrossRefPubMed Blackwell DL, Martinez ME, Gentleman JF: Women’s compliance with public health guidelines for mammograms and pap tests in Canada and the United States: an analysis of data from the Joint Canada/United States Survey Of Health. Womens Health Issues. 2008, 18: 85-99. 10.1016/j.whi.2007.10.006.CrossRefPubMed
4.
go back to reference Maxwell CJ, Bancej CM, Snider J, Vik SA: Factors important in promoting cervical cancer screening among Canadian women: findings from the 1996–97 National Population Health Survey (NPHS). Can J Publ Health. 2001, 92: 127-133. Maxwell CJ, Bancej CM, Snider J, Vik SA: Factors important in promoting cervical cancer screening among Canadian women: findings from the 1996–97 National Population Health Survey (NPHS). Can J Publ Health. 2001, 92: 127-133.
5.
go back to reference Mitchell RS, Padwal RS, Chuck AW, Klarenbach SW: Cancer screening among the overweight and obese in Canada. Am J Prev Med. 2008, 35: 127-132. 10.1016/j.amepre.2008.03.031.CrossRefPubMed Mitchell RS, Padwal RS, Chuck AW, Klarenbach SW: Cancer screening among the overweight and obese in Canada. Am J Prev Med. 2008, 35: 127-132. 10.1016/j.amepre.2008.03.031.CrossRefPubMed
6.
go back to reference Young TK, Kliewer E, Blanchard J, Mayer T: Monitoring disease burden and preventive behavior with data linkage: cervical cancer among aboriginal people in Manitoba, Canada. Am J Publ Health. 2000, 90: 1466-1468.CrossRef Young TK, Kliewer E, Blanchard J, Mayer T: Monitoring disease burden and preventive behavior with data linkage: cervical cancer among aboriginal people in Manitoba, Canada. Am J Publ Health. 2000, 90: 1466-1468.CrossRef
7.
go back to reference Puig-Tintore LM, Castellsague X, Torne A: Coverage and factors associated with cervical cancer screening: results from the AFRODITA study: a population-based survey in Spain. J Low Genit Tract Dis. 2008, 12: 82-89. 10.1097/LGT.0b013e3181599c16.CrossRefPubMed Puig-Tintore LM, Castellsague X, Torne A: Coverage and factors associated with cervical cancer screening: results from the AFRODITA study: a population-based survey in Spain. J Low Genit Tract Dis. 2008, 12: 82-89. 10.1097/LGT.0b013e3181599c16.CrossRefPubMed
8.
go back to reference Smith AM, Heywood W, Ryall R: Association between sexual behavior and cervical cancer screening. J Womens Health (Larchmt). 2011, 20: 1091-1096. 10.1089/jwh.2010.2585.CrossRef Smith AM, Heywood W, Ryall R: Association between sexual behavior and cervical cancer screening. J Womens Health (Larchmt). 2011, 20: 1091-1096. 10.1089/jwh.2010.2585.CrossRef
9.
go back to reference Kelly J, Lanier A, Santos M: Cancer among the circumpolar Inuit, 1989–2003. II. Patterns and trends. Int J Circumpolar Health. 2008, 67: 408-420.PubMed Kelly J, Lanier A, Santos M: Cancer among the circumpolar Inuit, 1989–2003. II. Patterns and trends. Int J Circumpolar Health. 2008, 67: 408-420.PubMed
10.
go back to reference Louchini R, Beaupre M: Cancer incidence and mortality among Aboriginal people living on reserves and northern villages in Quebec, 1988–2004. Int J Circumpolar Health. 2008, 67: 445-451.CrossRefPubMed Louchini R, Beaupre M: Cancer incidence and mortality among Aboriginal people living on reserves and northern villages in Quebec, 1988–2004. Int J Circumpolar Health. 2008, 67: 445-451.CrossRefPubMed
11.
go back to reference Healey SM, Aronson KJ, Mao Y: Oncogenic human papillomavirus infection and cervical lesions in aboriginal women of Nunavut, Canada. Sex Transm Dis. 2001, 28: 694-700. 10.1097/00007435-200112000-00006.CrossRefPubMed Healey SM, Aronson KJ, Mao Y: Oncogenic human papillomavirus infection and cervical lesions in aboriginal women of Nunavut, Canada. Sex Transm Dis. 2001, 28: 694-700. 10.1097/00007435-200112000-00006.CrossRefPubMed
12.
go back to reference Hamlin-Douglas LK, Coutlee F, Roger M, Franco EL, Brassard P: Prevalence and age distribution of human papillomavirus infection in a population of Inuit women in Nunavik, Quebec. Canc Epidemiol Biomarkers Prev. 2008, 17: 3141-3149. 10.1158/1055-9965.EPI-08-0625.CrossRef Hamlin-Douglas LK, Coutlee F, Roger M, Franco EL, Brassard P: Prevalence and age distribution of human papillomavirus infection in a population of Inuit women in Nunavik, Quebec. Canc Epidemiol Biomarkers Prev. 2008, 17: 3141-3149. 10.1158/1055-9965.EPI-08-0625.CrossRef
13.
go back to reference Walboomers JM, Jacobs MV, Manos MM: Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999, 189: 12-19. 10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F.CrossRefPubMed Walboomers JM, Jacobs MV, Manos MM: Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999, 189: 12-19. 10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F.CrossRefPubMed
14.
go back to reference Statistics Canada: Aboriginal Peoples in Canada in 2006. 2008, Ottawa: Inuit, Metis and First Nations, 2006 Census Statistics Canada: Aboriginal Peoples in Canada in 2006. 2008, Ottawa: Inuit, Metis and First Nations, 2006 Census
15.
go back to reference Vasilevska M, Ross SA, Gesink D, Fisman DN: Relative risk of cervical cancer in indigenous women in Australia, Canada, New Zealand, and the United States: a systematic review and meta-analysis. J Public Health Policy. 2012, 33: 148-164. 10.1057/jphp.2012.8.CrossRefPubMed Vasilevska M, Ross SA, Gesink D, Fisman DN: Relative risk of cervical cancer in indigenous women in Australia, Canada, New Zealand, and the United States: a systematic review and meta-analysis. J Public Health Policy. 2012, 33: 148-164. 10.1057/jphp.2012.8.CrossRefPubMed
16.
go back to reference Dodin S, Blanchet C: Women’s Health and Preventive Sexual Behaviour in Men and Women. 2007, Nunavik Regional Board of Health and Social Services: Institut national de santé publique du Québec Dodin S, Blanchet C: Women’s Health and Preventive Sexual Behaviour in Men and Women. 2007, Nunavik Regional Board of Health and Social Services: Institut national de santé publique du Québec
17.
go back to reference Bowman JA, Sanson-Fisher R, Redman S: The accuracy of self-reported Pap smear utilisation. Soc Sci Med. 1997, 44: 969-976. 10.1016/S0277-9536(96)00222-5.CrossRefPubMed Bowman JA, Sanson-Fisher R, Redman S: The accuracy of self-reported Pap smear utilisation. Soc Sci Med. 1997, 44: 969-976. 10.1016/S0277-9536(96)00222-5.CrossRefPubMed
18.
go back to reference Howard M, Agarwal G, Lytwyn A: Accuracy of self-reports of Pap and mammography screening compared to medical record: a meta-analysis. Cancer Causes Control. 2009, 20: 1-13. 10.1007/s10552-008-9228-4.CrossRefPubMed Howard M, Agarwal G, Lytwyn A: Accuracy of self-reports of Pap and mammography screening compared to medical record: a meta-analysis. Cancer Causes Control. 2009, 20: 1-13. 10.1007/s10552-008-9228-4.CrossRefPubMed
19.
go back to reference Hamlin-Douglas LK, Coutlee F, Roger M, Hanley J, Franco EL, Brassard P: Determinants of human papillomavirus infection among inuit women of northern Quebec, Canada. Sex Transm Dis. 2010, 37: 377-381.PubMed Hamlin-Douglas LK, Coutlee F, Roger M, Hanley J, Franco EL, Brassard P: Determinants of human papillomavirus infection among inuit women of northern Quebec, Canada. Sex Transm Dis. 2010, 37: 377-381.PubMed
21.
go back to reference Goggin P, Mayrand M-H: Recommendations on optimizing cervical cancer screening in Québec. 2009, Québec: Institut national de santé publique du Québec Goggin P, Mayrand M-H: Recommendations on optimizing cervical cancer screening in Québec. 2009, Québec: Institut national de santé publique du Québec
22.
go back to reference Miettinen OS: Stratification by a multivariate confounder score. Am J Epidemiol. 1976, 104: 609-620.PubMed Miettinen OS: Stratification by a multivariate confounder score. Am J Epidemiol. 1976, 104: 609-620.PubMed
24.
go back to reference Lofters AK, Moineddin R, Hwang SW, Glazier RH: Low rates of cervical cancer screening among urban immigrants: a population-based study in Ontario, Canada. Med Care. 2010, 48: 611-618. 10.1097/MLR.0b013e3181d6886f.CrossRefPubMed Lofters AK, Moineddin R, Hwang SW, Glazier RH: Low rates of cervical cancer screening among urban immigrants: a population-based study in Ontario, Canada. Med Care. 2010, 48: 611-618. 10.1097/MLR.0b013e3181d6886f.CrossRefPubMed
25.
go back to reference Statement on human papillomavirus vaccine: An Advisory Committee Statement (ACS). Can Commun Dis Rep. 2007, 33: 1-31. Statement on human papillomavirus vaccine: An Advisory Committee Statement (ACS). Can Commun Dis Rep. 2007, 33: 1-31.
26.
go back to reference Van Til L, MacQuarrie C, Herbert R: Understanding the barriers to cervical cancer screening among older women. Qual Health Res. 2003, 13: 1116-1131. 10.1177/1049732303255975.CrossRefPubMed Van Til L, MacQuarrie C, Herbert R: Understanding the barriers to cervical cancer screening among older women. Qual Health Res. 2003, 13: 1116-1131. 10.1177/1049732303255975.CrossRefPubMed
27.
go back to reference Black AT, McCulloch A, Martin RE, Kan L: Young women and cervical cancer screening: what barriers persist?. Can J Nurs Res. 2011, 43: 8-21.PubMed Black AT, McCulloch A, Martin RE, Kan L: Young women and cervical cancer screening: what barriers persist?. Can J Nurs Res. 2011, 43: 8-21.PubMed
28.
go back to reference Gerard D: Socio-economic profile of Nunavik. 2008, Québec: Canada Research Chair in Comparative Aboriginal Condition, 2008 Gerard D: Socio-economic profile of Nunavik. 2008, Québec: Canada Research Chair in Comparative Aboriginal Condition, 2008
30.
go back to reference Cerigo H, Macdonald ME, Franco EL, Brassard P: Inuit women’s attitudes and experiences towards cervical cancer and prevention strategies in Nunavik, Quebec. Int J Circumpolar Health. 2012, 71: 17996-10.3402/ijch.v71i0.17996.CrossRefPubMed Cerigo H, Macdonald ME, Franco EL, Brassard P: Inuit women’s attitudes and experiences towards cervical cancer and prevention strategies in Nunavik, Quebec. Int J Circumpolar Health. 2012, 71: 17996-10.3402/ijch.v71i0.17996.CrossRefPubMed
31.
go back to reference Waller J, Jackowska M, Marlow L, Wardle J: Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study. BJOG. 2011, 119: 26-32.CrossRefPubMed Waller J, Jackowska M, Marlow L, Wardle J: Exploring age differences in reasons for nonattendance for cervical screening: a qualitative study. BJOG. 2011, 119: 26-32.CrossRefPubMed
32.
go back to reference Coe K, Martin L, Nuvayestewa L: Predictors of Pap test use among women living on the Hopi reservation. Health Care Women Int. 2007, 28: 764-781. 10.1080/07399330701562956.CrossRefPubMed Coe K, Martin L, Nuvayestewa L: Predictors of Pap test use among women living on the Hopi reservation. Health Care Women Int. 2007, 28: 764-781. 10.1080/07399330701562956.CrossRefPubMed
33.
go back to reference Franco EL: Chapter 13: Primary screening of cervical cancer with human papillomavirus tests. J Natl Canc Inst Monogr. 2003, 31: 89-96.CrossRef Franco EL: Chapter 13: Primary screening of cervical cancer with human papillomavirus tests. J Natl Canc Inst Monogr. 2003, 31: 89-96.CrossRef
34.
go back to reference Cuzick J, Sasieni P, Davies P: A systematic review of the role of human papilloma virus (HPV) testing within a cervical screening programme: summary and conclusions. Br J Cancer. 2000, 83: 561-565. 10.1054/bjoc.2000.1375.CrossRefPubMedPubMedCentral Cuzick J, Sasieni P, Davies P: A systematic review of the role of human papilloma virus (HPV) testing within a cervical screening programme: summary and conclusions. Br J Cancer. 2000, 83: 561-565. 10.1054/bjoc.2000.1375.CrossRefPubMedPubMedCentral
Metadata
Title
Factors associated with cervical cancer screening uptake among Inuit women in Nunavik, Quebec, Canada
Authors
Helen Cerigo
Francois Coutlée
Eduardo L Franco
Paul Brassard
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-438

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