UICC World Cancer Congress 2006

Objective:To assess the role of immigration in Pap testing rates after controlling for socioeconomic factors. Methods: We analyzed 4 years of self-reported data from the National Health Interview Survey (1998-2000 and 2003)to report Pap testing rates by birthplace and percent lifetime in US for women >= 18 years old (n=70, 775). Multivariable logistic regression models were fit to determine the effect of birth place and recency of immigration on Pap testing rates after adjusting for differences in the demographic and health care access factors. Adjusted screening percentages for US born and foreign born women are presented as predictive margins from the regression models. Results: Among the 12% or an estimated 12.3 million foreign born women in the study population, 69.7% (95% CI 65.8, 71.7) of recent immigrants (< 25% of lifetime in US) and 86.5% (95% CI 85.2, 87.8) of established immigrants (<=25% of lifetime in US) have ever received a Pap test compared to 93.0% (95% CI 92.8, 93.2) of US born women. After adjusting for several factors known to influence Pap testing rates, this rate was 81.5% among recent immigrants and 90.4% among more established immigrants (vs. 94.2% among US born women). Conclusion: Significant differences still exist in cervical cancer screening rates between immigrant and US born women after controlling for access issues, possibly due to acculturation factors. Nationally and locally funded cervical cancer screening programs may benefit from these findings in developing separate screening strategies for recently vs. more established immigrant women by region of origin.