Cervical screening uptake: A cross-sectional study of self-reported screening attitudes, behaviours and barriers to participation among South Asian immigrant women living in Australia

Abstract

Introduction: Cervical cancer remains a major cause of morbidity and mortality among women from low and lower middle-income countries, as well as underserved population subgroups in high-income countries. Migration from South Asia to Australia has increased over the last decade, and immigrant women from this region have been reported as a subgroup, with less than optimal cervical screening participation in Australia. This study examined cervical screening uptake and associated behavioural attitudes among South Asian immigrant women living in Queensland Australia. Methods: A cross-sectional, Internet-based survey was used to collect data from a convenience sample of 148 South Asian women living in Queensland. The main outcome measure was receipt of cervical screening test ever (yes/no) and its recency (within 2 years/more than 2 years). The survey also examined participants’ views on barriers towards screening and ways to enhance it. Results: Of 148 women who completed the survey, 55.4% (n = 82) reported ever having a cervical screening test before and 43.9% (n = 65) reported having it in previous two years. Not having a previous cervical screening test was significantly associated with duration of stay in Australia for less than five years, not having access to a regular general practitioner (GP), not being employed, having low cervical cancer knowledge level and not knowing if cervical screening test is painful or not. Most commonly reported barriers to screening uptake included considering oneself not at risk, lack of time and lack of information. The most favoured strategy among participants was encouragement by GP and awareness through social media advertisements. Conclusion: This study provided insights into factors that need consideration when developing future targeted interventions.

Barriers to cervical cancer screening faced by immigrant Muslim women: a systematic scoping review

“…Economic difficulties were also experienced by immigrant women in a study in Oslo, which found that immigrant women directed their focus towards meeting their family's basic needs rather than their own health concerns [ 6 ]. The lack of health insurance significantly reduced the desire of immigrant women in the US and Australia to attend a screening site [ 21 , 22 ]. Moreover, Islam et al (2017) reported that immigration status and fear of being deported often acted as barriers preventing many women from undergoing screening in the US [ 17 ].…”

“…Immigrant Muslim women from different ethnic backgrounds in European countries and Australia also described feeling shy when discussing CCS. This was also the experience of some Indian women and black women who perceived this as a barrier to screening, particularly among the older generation who feel that their body is a private and sensitive area [ 9 , 20 , 21 ]. Moreover, most women in the US, Canada, London, Scotland, and Dubai stated that pain during the CCS procedure and fear of cancer were major factors contributing to low CCS rates, followed by discomfort during the procedure [ 3 , 6 , 14 , 18 , 20 , 26 ].…”

“…Regarding negative attitudes and readiness for CCS, embarrassment, shame, and pain were the biggest challenges for immigrant Muslim women [ 8 , 9 , 12 , 14 , 21 , 26 ]. One study found strong resistance to the need to expose the female genitalia during screening and stated that discussing or participating in the screening test itself caused embarrassment [ 17 ].…”

“…Cervical screening was frequently described as a painful and uncomfortable procedure, particularly during the first experience [ 26 ]. Participants who were unsure about whether CCS was painful were less likely to undergo the screening than those who assumed the exam was not painful [ 21 ]. However, some women expressed a positive desire to have a checkup as soon as possible, indicating that it was easier, less painful, and shorter to undergo a gynecological examination after delivery [ 19 ].…”