Cervical cancer screening among urban immigrants by region of origin: a population-based cohort study

Prev Med. 2010 Dec;51(6):509-16. doi: 10.1016/j.ypmed.2010.09.014. Epub 2010 Oct 7.


Objectives: We compared the prevalence of appropriate cervical cancer screening among screening-eligible immigrant women from major geographic regions of the world and native-born women.

Methods: We determined the proportion of women who were screened during the three-year period of 2006-2008 among 2.9 million screening-eligible women living in urban centres in Ontario, Canada. In multivariate analyses, we adjusted for numerous variables including age, neighbourhood-level income, and prenatal visits during the study period.

Results: 61.3% of women were up-to-date on cervical cancer screening. Screening rates were lowest among women from South Asia when compared to the referent group (Canadian-born women and immigrants who arrived before 1985) (adjusted rate ratio 0.81, 95% CI [0.80-0.82] among women aged 18-49 years, adjusted rate ratio 0.67 [0.65-0.69] among women aged 50-66 years). Of the older South Asian women living in the lowest-income neighbourhoods and not in a primary care enrollment model, 21.9% had been appropriately screened. In contrast, among Canadian-born women living in the highest-income neighbourhoods and in a primary care enrollment model, 79.0% had been appropriately screened.

Conclusion: Efforts to reduce cervical cancer screening disparities should focus on women living in the lowest-income neighbourhoods and women from South Asia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Asia, Southeastern / ethnology
  • Cohort Studies
  • Emigrants and Immigrants*
  • Female
  • Healthcare Disparities*
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Ontario / epidemiology
  • Poverty Areas
  • Urban Health
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / ethnology*
  • Uterine Cervical Neoplasms / prevention & control
  • Vaginal Smears
  • Young Adult