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Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal

BACKGROUND: The province of Quebec (Canada) has implemented a breast cancer screening program to diagnose this cancer at an early stage. The strategy is to refer women 50 to 69 years old for a mammogram every two years by sending an invitation letter that acts as a prescription. Ninety per cent (90%...

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Autores principales: Raynault, Marie-France, Féthière, Christelle, Côté, Dominique
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685600/
https://www.ncbi.nlm.nih.gov/pubmed/33228706
http://dx.doi.org/10.1186/s12939-020-01322-0
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author Raynault, Marie-France
Féthière, Christelle
Côté, Dominique
author_facet Raynault, Marie-France
Féthière, Christelle
Côté, Dominique
author_sort Raynault, Marie-France
collection PubMed
description BACKGROUND: The province of Quebec (Canada) has implemented a breast cancer screening program to diagnose this cancer at an early stage. The strategy is to refer women 50 to 69 years old for a mammogram every two years by sending an invitation letter that acts as a prescription. Ninety per cent (90%) of deaths due to breast cancer occur in women aged 50 and over. Numerous studies have shown social inequalities in health for most diseases. With breast cancer, a significant paradox arises: its incidence is lower among disadvantaged women and yet, more of them die from this disease. The health care system might play a role in this inequality. The scientific literature documents the potential for creating such inequalities when prevention does not consider equity among social groups. Immigrant women are often disadvantaged. They die of breast cancer more than non-immigrants. Studies attribute this to late-stage diagnosis due to poor adherence to mammography screening programs. PURPOSE OF THE STUDY: The main objective of our research is to assess how Haitian immigrant women in Montreal are reached by the Quebec Breast Cancer Screening Program, and specifically how they perceive the mammogram referral letter sent by the program. METHODS: The study uses a two-step qualitative method: i) In-depth interviews with influential community workers to identify the most relevant issues; ii) Focus groups with disadvantaged women from Montreal’s Haitian community. RESULTS: A mammogram referral letter from the Breast Cancer Screening Program may be a barrier to compliance with mammography by underprivileged Haitian women in Montreal. This might be attributable to a low level of literacy, poor knowledge of the disease, and lack of financial resources. CONCLUSION: Barriers may be underestimated in underprivileged immigrant and non-immigrant communities. A preventive strategy must be adapted to different sub-groups and must also take into account lower literacy levels. To increase mammography uptake, it is crucial that the benefits of prevention be clearly identified and described in understandable terms. Finally, economic access to follow-up measures should be considered.
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spelling pubmed-76856002020-11-25 Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal Raynault, Marie-France Féthière, Christelle Côté, Dominique Int J Equity Health Research BACKGROUND: The province of Quebec (Canada) has implemented a breast cancer screening program to diagnose this cancer at an early stage. The strategy is to refer women 50 to 69 years old for a mammogram every two years by sending an invitation letter that acts as a prescription. Ninety per cent (90%) of deaths due to breast cancer occur in women aged 50 and over. Numerous studies have shown social inequalities in health for most diseases. With breast cancer, a significant paradox arises: its incidence is lower among disadvantaged women and yet, more of them die from this disease. The health care system might play a role in this inequality. The scientific literature documents the potential for creating such inequalities when prevention does not consider equity among social groups. Immigrant women are often disadvantaged. They die of breast cancer more than non-immigrants. Studies attribute this to late-stage diagnosis due to poor adherence to mammography screening programs. PURPOSE OF THE STUDY: The main objective of our research is to assess how Haitian immigrant women in Montreal are reached by the Quebec Breast Cancer Screening Program, and specifically how they perceive the mammogram referral letter sent by the program. METHODS: The study uses a two-step qualitative method: i) In-depth interviews with influential community workers to identify the most relevant issues; ii) Focus groups with disadvantaged women from Montreal’s Haitian community. RESULTS: A mammogram referral letter from the Breast Cancer Screening Program may be a barrier to compliance with mammography by underprivileged Haitian women in Montreal. This might be attributable to a low level of literacy, poor knowledge of the disease, and lack of financial resources. CONCLUSION: Barriers may be underestimated in underprivileged immigrant and non-immigrant communities. A preventive strategy must be adapted to different sub-groups and must also take into account lower literacy levels. To increase mammography uptake, it is crucial that the benefits of prevention be clearly identified and described in understandable terms. Finally, economic access to follow-up measures should be considered. BioMed Central 2020-11-23 /pmc/articles/PMC7685600/ /pubmed/33228706 http://dx.doi.org/10.1186/s12939-020-01322-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 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 in a credit line to the data.
spellingShingle Research
Raynault, Marie-France
Féthière, Christelle
Côté, Dominique
Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal
title Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal
title_full Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal
title_fullStr Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal
title_full_unstemmed Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal
title_short Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal
title_sort social inequalities in breast cancer screening: evaluating written communications with immigrant haitian women in montreal
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685600/
https://www.ncbi.nlm.nih.gov/pubmed/33228706
http://dx.doi.org/10.1186/s12939-020-01322-0
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