Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2020

Open Access 01-12-2020 | Cervical Cancer | Review

Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping review

Authors: Patrícia Marques, Mariana Nunes, Maria da Luz Antunes, Bruno Heleno, Sónia Dias

Published in: International Journal for Equity in Health | Issue 1/2020

Login to get access

Abstract

Background

Cervical cancer screening has been effective in reducing incidence and mortality of cervical cancer, leading European countries to implement screening programs. However, migrant women show lower screening participation compared to nationals. This scoping review aims to provide a synthesis of the growing evidence on factors associated with participation in cervical cancer screening among migrant women in Europe.

Methods

Electronic peer-reviewed databases were searched in November 2019 for studies on factors related to the participation of migrants in cervical cancer screening conducted in EU/EFTA countries, using comprehensive search expressions. Retrieved articles were screened and those eligible were selected for data extraction. Quantitative and qualitative studies were included. Factors were classified in barriers and facilitators and were divided into further categories.

Results

Twenty out of 96 articles were selected and analyzed. Factors associated with participation in cervical cancer screening were classified in categories related to sociodemographic, healthcare-system, psychological, migration, knowledge, language, and cultural factors. Lack of information, lack of female healthcare providers, poor language skills, and emotional responses to the test (especially fear, embarrassment and discomfort) were the most reported barriers to cervical cancer screening. Encouragement from healthcare providers and information available in migrants’ languages were frequently stated as facilitators. Results on the role of sociodemographic factors, such as age, education, employment and marital status, are the most conflicting, highlighting the complexity of the issue and the possibility of interactions between factors, resulting in different effects on cervical cancer screening participation among migrant women. Several identified barriers to screening are like those to access to healthcare services in general.

Conclusions

Efforts to increase migrant women’s participation in CCS must target barriers to access to healthcare services in general but also specific barriers, including cultural differences about sexuality and gender, past traumatic personal experiences, and the gender and competences of healthcare professionals performing CCS. Healthcare services should strengthen resources to meet migrants’ needs, including having CCS information translated and culturally adapted, as well as healthcare providers with skills to deal with cultural background. These findings can contribute to improve CCS programs among migrant women, reducing health disparities and enhancing their overall health and well-being.
Appendix
Available only for authorised users
Literature
1.
Karsa L von, Anttila A, Ronco G, Ponti A, Malila N, Arbyn M, et al. Cancer screening in the European Union. Report on the implementation of the Council Recommendation on cancer screening. Luxembourg: European Commission; 2008. p. 160.
2.
3.
Castellsagué X. Natural history and epidemiology of HPV infection and cervical cancer. Gynecol Oncol. 2008;110:4–7.
4.
Chrysostomou AC, Stylianou DC, Constantinidou A, Kostrikis LG. Cervical cancer screening programs in Europe: The transition towards HPV vaccination and population-based HPV testing. Viruses. 2018;10(12):729–35.
5.
WHO. Comprehensive Cervical Cancer Control - A guide to essential practice (2o Ed). Geneva. 2014. 366–378.
6.
Elfström KM, Arnheim-Dahlström L, Von Karsa L, Dillner J. Cervical cancer screening in Europe: quality assurance and organisation of programmes. Eur J Cancer. 2015;51(8):950–68.PubMed
7.
Arbyn M, Anttila A, Jordan J, Ronco G, Schenck U, Segnan N, et al. European guidelines for quality assurance in cervical document. Ann Oncol. 2010;21:448–58.PubMedPubMedCentral
8.
International Agency for Research on Cancer. IARC Handbooks of Cancer Prevention. Vol. 10: C. Lyon: IARC Press; 2005.
9.
Jansen EEL, Zielonke N, Gini A, Anttila A, De Koning HJ, De Kok IMCM. Effect of organised cervical cancer screening on cervical cancer mortality in Europe: a systematic review. Eur J Cancer. 2020;127:207–23.
10.
Basu P, Ponti A, Anttila A, Ronco G, Senore C, Vale DB, et al. Status of implementation and organization of cancer screening in the European Union member states — summary results from the second European screening report. Int J Cancer. 2018;142(1):44–56.PubMed
11.
Campari C, Fedato C, Iossa A, Petrelli A, Zorzi M, Anghinoni E, et al. Cervical cancer screening in immigrant women in Italy: a survey on participation , cytology and histology results. Eur J Cancer Prev. 2016;25(4):321–8.PubMed
12.
Azerkan F, Sparén P, Sandin S, Tillgren P, Faxelid E, Zendehdel K, et al. Cervical screening participation and risk among Swedish-born and immigrant women in Sweden. Int J Cancer. 2012;130(4):937–47.PubMed
13.
Van Leeuwen AWFM, De Nooijer P, Hop WCJ. Screening for cervical carcinoma: participation and results for ethnic groups and socioeconomic status. Cancer. 2005;105(5):270–6.PubMed
14.
Spence AR, Alobaid A, Drouin P, Goggin P, Gilbert L, Provencher D, et al. Screening histories and contact with physicians as determinants of cervical cancer risk in Montreal, Quebec. Curr Oncol. 2014;21(6):294–304.PubMedPubMedCentral
15.
Visioli CB, Crocetti E, Zappa M, Iossa A, Andersson KL, Bulgaresi P, et al. Participation and risk of high grade cytological lesions among immigrants and Italian-born women in an organized cervical cancer screening program in Central Italy. J Immigr Minor Health. 2015;17(3):670–8.PubMed
16.
WHO. Report on the health of refugees and migrants in the WHO European Region. 2019.
17.
Norredam M, Nielsen SS, Krasnik A. Migrants ’ utilization of somatic healthcare services in Europe — a systematic review. Eur J Pub Health. 2009;20(5):555–63.
18.
Graetz V, Rechel B, Groot W, Norredam M, Pavlova M. Utilization of health care services by migrants in Europe - a systematic literature review. Br Med Bull. 2017;121:5–18.PubMed
19.
Rosano A, Dauvrin M, Buttigieg SC, Ronda E, Tafforeau J, Dias S. Migrant’s access to preventive health services in five EU countries. BMC Health Serv Res. 2017;17(1):1–11.
20.
Oliveira CR, Gomes N. Indicadores de Integração de Imigrantes - Relatório estatístico anual 2018; 2018.
21.
Almeida LM, Casanova C, Caldas J, Ayres-De-Campos D, Dias S. Migrant women’s perceptions of healthcare during pregnancy and early motherhood: addressing the social determinants of health. J Immigr Minor Health. 2014;16(4):719–23.PubMed
22.
Dauvrin M, Lorant V, Sandhu S, Devillé W, Dia H, Dias S, et al. Health care for irregular migrants: Pragmatism across Europe. A qualitative study. BMC Res Notes. 2012;5(1):99.PubMedPubMedCentral
23.
Dias S, Gama A, Silva AC, Cargaleiro H, Martins MO. Barreiras no acesso e utilização dos serviços de saúde pelos imigrantes. Acta Medica Port. 2011;24(4):511–6.
24.
Dias S, Gama A, Cortes M, de Sousa B. Healthcare-seeking patterns among immigrants in Portugal. Heal Soc Care Community. 2011;19(5):514–21.
25.
Marlow LA V, Wardle J, Waller J. Understanding cervical screening non-attendance among ethnic minority women in England. Br J Cancer 2015;113:833–839.
26.
Anaman-torgbor JA, King J, Correa-Velez I. Barriers and facilitators of cervical cancer screening practices among African immigrant women living in Brisbane, Australia. Eur J Oncol Nurs. 2017;31:22–9.PubMed
27.
Gele AA, Qureshi SA, Kour P, Kumar B, Diaz E. Barriers and facilitators to cervical cancer screening among Pakistani and Somali immigrant women in Oslo: a qualitative study. Int J Women's Health. 2017;9:487–96.
28.
29.
30.
Koon A, Hawkins B, Mayhew S. Framing and the health policy process: a scoping review. Health Policy Plan. 2016;2016:1–16.
31.
Levac D, Colquhoun H, O’Brien KK. Scoping studies: Advancing the methodology. Implement Sci. 2010;5(1):69–9.
32.
Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):143–7.
33.
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Vol. 169, Annals of Internal Medicine. Am College Physicians; 2018; 467–473.
34.
35.
Májek O, Anttila A, Arbyn M, Van Veen E Ben, Engesæter B, Lönnberg S. The legal framework for European cervical cancer screening programmes. Eur J Pub Health 2018;29(2):1–6.
36.
Ferdous M, Lee S, Goopy S, Yang H, Rumana N, Abedin T. Barriers to cervical cancer screening faced by immigrant women in Canada: a systematic scoping review. BMC Womens Health. 2018;18(165):1–13.
37.
Abdullahi A, Copping J, Kessel A, Luck M, Bonell C. Cervical screening: perceptions and barriers to uptake among Somali women in Camden. Public Health. 2009;123(10):680–5.PubMed
38.
Otero L, Sanz B, Blasco T. Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain. Rev Saude Publica. 2011;45(5):824–30.PubMed
39.
Jackowska M, Von Wagner C, Wardle J, Juszczyk D, Luszczynska A, Waller J. Cervical screening among migrant women: a qualitative study of polish, Slovak and Romanian women in London, UK. J Fam Plan Reprod Heal Care. 2012;38(4):229–38.
40.
Rodríguez-Salés V, Roura E, Ibañez R, Peris M, Xavier Bosch F, de Sanjosé S. Coverage of cervical cancer screening in Catalonia for the period 2008-2011 among immigrants and Spanish-born women. Front Oncol. 2013;3:297–7.
41.
Olsson E, Lau M, Lifvergren S, Chakhunashvili A. Community collaboration to increase foreign-born women’s participation in a cervical cancer screening program in Sweden: A quality improvement project. Int J Equity Health. 2014;13(1):62–10.
42.
Azerkan F, Widmark C, Sparén P, Weiderpass E, Tillgren P, Faxelid E. When life got in the way: how danish and norwegian immigrant women in Sweden reason about cervical screening and why they postpone attendance. PLoS One. 2015;10(7):1–22.
43.
Grandahl M, Tydén T, Gottvall M, Westerling R, Oscarsson M. Immigrant women’s experiences and views on the prevention of cervical cancer: a qualitative study. Health Expect. 2015;18(3):344–54.PubMed
44.
Akhagba OM. Migrant women’s knowledge and perceived sociocultural barriers to cervical cancer screening programme: a qualitative study of African women in Poland. Heal Psychol Rep. 2017;3(3):263–71.
45.
Bianco A, Larosa E, Pileggi C, Nobile CGAA, Pavia M. Cervical and breast cancer screening participation and utilisation of maternal health services: a cross-sectional study among immigrant women in southern Italy. BMJ Open. 2017;7(10):e016306.PubMedPubMedCentral
46.
Comparetto C, Epifani C, Manca MC, Lachheb A, Bravi S, Cipriani F, et al. Uptake of cervical cancer screening among the migrant population of Prato Province, Italy. Int J Gynecol Obstet. 2017;136(3):309–14.
47.
Gallo F, Caprioglio A, Castagno R, Ronco G, Segnan N, Giordano L. Inequalities in cervical cancer screening utilisation and results: a comparison between Italian natives and immigrants from disadvantaged countries. Health Policy. 2017;121(10):1072–8.PubMed
48.
Idehen EE, Korhonen T, Castaneda A, Juntunen T, Kangasniemi M, Pietilä AM, et al. Factors associated with cervical cancer screening participation among immigrants of Russian, Somali and Kurdish origin: a population-based study in Finland. BMC Public Health. 2017;17(19):1–10.
49.
Møen KA, Kumar B, Qureshi S, Diaz E. Differences in cervical cancer screening between immigrants and nonimmigrants in Norway: a primary healthcare register-based study. Eur J Cancer Prev. 2017;26(6):521–7.PubMedPubMedCentral
50.
Addawe MA, Brux Mburu C, Madar A. Barriers to cervical cancer screening: a qualitative study among Somali women in Oslo Norway. Heal Prim Care. 2018;2(1):1–5.
51.
Idehen EE, Koponen P, Härkänen T, Kangasniemi M, Pietilä AM, Korhonen T. Disparities in cervical screening participation: a comparison of Russian, Somali and Kurdish immigrants with the general Finnish population. Int J Equity Health. 2018;17(56):1–9.
52.
Møen KA, Terragni L, Kumar B, Diaz E. Cervical cancer screening among immigrant women in Norway- the healthcare providers’ perspectives. Scand J Prim Health Care. 2018;36(4):415–22.PubMedPubMedCentral
53.
Barrera-Castillo M, Fernández-Peña R, del Valle-Gómez M del O, Fernández-Feito A, Lana A. Social integration and gynecologic cancer screening of immigrant women in Spain. Gac Sanit. 2019;34(5):468–73.
54.
Hertzum-Larsen R, Kjær SK, Frederiksen K, Thomsen LT. Participation in cervical cancer screening among immigrants and Danish-born women in Denmark. Prev Med (Baltim). 2019;123:55–64.
55.
IOM. Migration and health: Current issues, governance and knowledge gaps. In: World Migration Report 2020; 2019. p. 212–49.
56.
Redwood-campbell L, Fowler N, Laryea S, Howard M, Kaczorowski J. ‘Before you teach me, I Cannot Know’: Immigrant Women’s Barriers and Enablers With Regard to Cervical Cancer Screening Among Different Ethnolinguistic Groups in Canada 2011;102(3):230–4.
57.
Karwalajtys TL, Redwood-Campbell LJ, Fowler NC, Lohfeld LH, Howard M, Kaczorowski JA, et al. Conducting qualitative research on cervical cancer screening among diverse groups of immigrant women: Research reflections: Challenges and solutions. Can Fam Physician. 2010;56(4):e130–5.
58.
Van Loenen T, Van Den Muijsenbergh M, Hofmeester M, Dowrick C, Van Ginneken N, Mechili EA, et al. Primary care for refugees and newly arrived migrants in Europe: a qualitative study on health needs, barriers and wishes. Eur J Pub Health. 2018;28(1):82–7.
59.
Gerend MA, Shepherd MA, Kaltz EA, Davis WJ, Shepherd JE. Understanding women’s hesitancy to undergo less frequent cervical cancer screening. Prev Med (Baltim). 2017;95:96–102.
60.
Pearlman DN, Clark MA, Rakowski W, Ehrich B. Screening for breast and cervical cancers: the importance of knowledge and perceived cancer survivability. Women Health. 1999;28(4):93–112.PubMed
61.
Grangé G, Malvy D, Lançon F, Gaudin A-F, El Hasnaoui A. Factors associated with regular cervical cancer screening. Int J Gynecol Obstet. 2008;102(1):28–33.
62.
Pratt R, Mohamed S, Dirie W, Ahmed N, Lee S, VanKeulen M, et al. Testing a religiously tailored intervention with Somali American Muslim women and Somali American imams to increase participation in breast and cervical Cancer screening. J Immigr Minor Health. 2020;22(1):87–95.PubMed
63.
Woloshin S, Schwartz LM, Katz SJ, Welch HG. Is language a barrier to the use of preventive services? J Gen Intern Med. 1997;12(8):472–7.PubMedPubMedCentral
64.
Luque JS, Tarasenko YN, Reyes-Garcia C, Alfonso ML, Suazo N, Rebing L, et al. Salud es Vida: a cervical Cancer screening intervention for rural Latina immigrant women. J Cancer Educ. 2017;32(4):690–9.PubMedPubMedCentral
65.
Luque JS, Tyson DM, Markossian T, Lee JH, Turner R, Proctor S, et al. Increasing cervical cancer screening in a Hispanic migrant farmworker community through faith-based clinical outreach. J Low Genit Tract Dis. 2011;15(3):200–4.PubMedPubMedCentral
66.
Fang CY, Ma GX, Handorf EA, Feng Z, Tan Y, Rhee J, et al. Addressing multilevel barriers to cervical Cancer screening in Korean American women: a randomized trial of a community- based intervention. Cancer. 2017;123(6):1018–26.PubMed
67.
European Migration Network. Annual Report on Migration and Asylum 2018. Directorate general migration and home affairs, European Commission; 2019.
Metadata
Title
Factors associated with cervical cancer screening participation among migrant women in Europe: a scoping review
Authors
Patrícia Marques
Mariana Nunes
Maria da Luz Antunes
Bruno Heleno
Sónia Dias
Publication date
01-12-2020
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2020
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-020-01275-4

Other articles of this Issue 1/2020

International Journal for Equity in Health 1/2020 Go to the issue

Research

All-cause mortality rate in China: do residents in economically developed regions have better health?

Research

Tracking health sector priority setting processes and outcomes for human resources for health, five-years after political devolution: a county-level case study in Kenya

Research

The politics and practice of initiating a public health postgraduate programme in three universities in sub-Saharan Africa: the challenges of alignment and coherence

Research

Inequality in healthcare use among older people in Colombia

Research

Social exclusion and universal health coverage: health care rights and citizen-led accountability in Guatemala and Peru

Research

A methodology for small area prevalence estimation based on survey data