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

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 wo...

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Autores principales: Vahabi, Mandana, Lofters, Aisha, Kumar, Matthew, Glazier, Richard H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508905/
https://www.ncbi.nlm.nih.gov/pubmed/26194189
http://dx.doi.org/10.1186/s12889-015-2050-5
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author Vahabi, Mandana
Lofters, Aisha
Kumar, Matthew
Glazier, Richard H.
author_facet Vahabi, Mandana
Lofters, Aisha
Kumar, Matthew
Glazier, Richard H.
author_sort Vahabi, Mandana
collection PubMed
description 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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spelling pubmed-45089052015-07-22 Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada Vahabi, Mandana Lofters, Aisha Kumar, Matthew Glazier, Richard H. BMC Public Health Research Article 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. BioMed Central 2015-07-21 /pmc/articles/PMC4508905/ /pubmed/26194189 http://dx.doi.org/10.1186/s12889-015-2050-5 Text en © Vahabi et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Vahabi, Mandana
Lofters, Aisha
Kumar, Matthew
Glazier, Richard H.
Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada
title Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada
title_full Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada
title_fullStr Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada
title_full_unstemmed Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada
title_short Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada
title_sort breast cancer screening disparities among urban immigrants: a population-based study in ontario, canada
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508905/
https://www.ncbi.nlm.nih.gov/pubmed/26194189
http://dx.doi.org/10.1186/s12889-015-2050-5
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