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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada

Zeitschrift:
BMC Public Health > Ausgabe 1/2015
Autoren:
Mandana Vahabi, Aisha Lofters, Matthew Kumar, Richard H. Glazier
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MV took primary responsibility for the design of the study, the acquisition, analysis and interpretation of data, and drafting and revising the article. AL and RG provided input and direction for the study design, and data acquisition, analysis, and interpretation. MK helped with acquisition and analysis of data. All authors revised the article critically for important intellectual content. All authors read and approved the final manuscript.

Abstract

Background

Breast cancer is one of the leading cause of mortality and morbidity in Canada. Screening is the most promising approach in identification and treatment of the disease at early stage of its development. Research shows higher rate of breast cancer mortality among ethno-racial immigrant women despite their lower incidence which suggests disparities in mammography screening. This study aimed to compare the prevalence of appropriate mammography screening among immigrant and native borne women and determine predicators of low mammography screening.

Methods

We conducted secondary data analyses on Ontario linked social and health databases to determine the proportion of women who were screened during the two- year period of 2010–2012 among 1.4 million screening-eligible women living in urban centres in Ontario. We used multivariate Poisson regression to adjust for various socio-demographic, health care-related and migration related variables.

Results

64 % of eligible women were appropriately screened. Screening rates were lowest among new and recent immigrants compared to referent group (Canadian-born women and immigrant who arrived before 1985) (Adjusted Rate Ratio (ARR) (0.87, 95 % CI 0.85 –0.88 for new immigrants and 0.90, 95 % CI 0.89–0.91 for recent immigrants. Factors that were associated with lower rates of screening included living in low- income neighborhoods, having a male physician, having internationally- trained physician and not being enrolled in primary care patient enrolment models. Those not enrolled were 22 % less likely to be screened compared to those who were (ARR 0.78, 95 % CI 0.77–0.79).

Conclusion

To enhance immigrant women screening rates efforts should made to increase their access to primary care patient enrolment models and preferably female health professionals. Support should be provided to interventions that address screening barriers like language, acculturation limitations and knowledge deficit. Health professionals need to be educated and take an active role in offering screening guidelines during health encounters.
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