Non-attendance in cervical cancer screening among migrant women in Portugal: A cross-sectional study

Abstract

Objectives: Cervical cancer has a high mortality rate among women worldwide. Although cervical cancer screening (CCS) is an effective strategy in reducing mortality of the disease, inequalities in accessing screening exist, particularly among migrant women. This study aims to characterize migrant women’s participation in CCS and determine factors associated with non-attendance to CCS. Methods: A cross-sectional study based on a web-based survey targeting adult migrant women living in Portugal was conducted. Prevalence of non-attendance to CCS was examined, and its associations with socioeconomic, migration-related, and health-related factors were determined using adjusted logistic regression models. Results: A total of 1100 migrant women were included in the study. Prevalence of CCS non-attendance was 24.5%. CCS non-attendance was associated with younger age, being born in Africa or Asia, being single/divorced/widowed, never having had a GP appointment in Portugal and not having regular gynecology appointments. Being born in South and Central America, shorter length of stay in Portugal, having had HPV vaccination, and not having children are associated with CCS attendance. Conclusion: These findings point out that an important percentage of migrant women do not attend CCS. Strategies to increase participation should be developed, considering the inequalities identified and designed to target the specific needs of migrant women to improve their CCS attendance and increase cervical cancer prevention.

Barriers to and Facilitators for Accessing HPV Vaccination in Migrant and Refugee Populations: A Systematic Review

“…When stratified by the WHO region of the study, the pooled adherence rate to the complete vaccination cycle was 63.4% based on the results of six studies conducted in Europe ([ 27 , 28 , 44 , 45 , 53 , 55 ]), and 6% according to nine studies conducted in the AMR. According to the only study carried out in the EUR, people’s vaccine initiation rate was 20.8% [ 53 ], whereas according to five studies conducted in the AMR, the pooled rate was 32.8% [ 43 , 47 , 48 , 49 , 50 , 51 , 54 ].…”

“…Stratifying by migratory status, the results of 13 studies show a pooled rate of 44.7% adherence for international migrants [ 27 , 28 , 29 , 43 , 44 , 45 , 47 , 48 , 49 , 50 , 52 , 53 , 55 ], and according to 4 studies, refugees’ pooled adherence rate was 0.6% [ 25 , 51 , 54 , 56 ]. On the other hand, the initiation pooled rates were, respectively, 14.9 [ 43 , 47 , 48 , 49 , 50 , 53 ] and 48% [ 51 , 54 ].…”

“…On the other hand, the initiation pooled rates were, respectively, 14.9 [ 43 , 47 , 48 , 49 , 50 , 53 ] and 48% [ 51 , 54 ]. Further stratifying by sex, female international migrants’ pooled adherence rate was 45.4% [ 27 , 29 , 43 , 44 , 45 , 47 , 48 , 49 , 50 , 52 , 53 , 55 ], while for female refugees, it was 27.7% [ 25 , 51 ]. The initiation pooled rate for female international migrants and refugees was 18.0% [ 47 , 48 , 49 , 50 , 53 ] and 13.8% [ 51 ], respectively.…”

“…In these studies, people suggested ways to provide such information, for instance, educational workshops to raise awareness about health topics among the youth [ 25 , 30 ], or information given by the provider, in both oral and written form, so people better retain the acquired knowledge [ 29 ]. Some others preferred to receive health information through digital media [ 25 , 29 , 40 , 55 ]. In any case, people seemed to express the need for a more user-friendly approach.…”

Addressing Cervical Cancer Screening Through Self-Sampling and HPV Testing Among Under-Screened Women: A Case Study in the Decentralized Portuguese Setting

“…Another study noted lower screening adherence among economically disadvantaged and less health-conscious Portuguese women 23 . For migrant women in Portugal, non-attendance is associated with younger age, being born in Africa or Asia, single/divorced/widowed status, no previous consultation with a General Practitioner in Portugal, and infrequent gynaecological check-ups 24 .…”