Cervical cancer screening among vulnerable women: factors affecting guideline adherence at a community health centre in Toronto, Ont.

OBJECTIVE

To see if refugee women at a community health centre (CHC) in Toronto, Ont, are appropriately screened for cervical cancer and if there are any demographic characteristics that affect whether they are screened.

DESIGN

Chart review.

SETTING

A CHC in downtown Toronto.

PARTICIPANTS

A total of 357 eligible refugee women attending the CHC.

MAIN OUTCOME MEASURES: Papanicolaou test received or documented reason for no Pap test.

RESULTS

Ninety-two percent of women in the study sample were either appropriately screened for cervical cancer or had been approached for screening. Eighty percent of women were appropriately screened. Demographic variables including pregnancy, being uninsured, not speaking English, recent migration to Canada, and being a visible minority did not affect receipt of a Pap test after migration in multivariate analyses. Not speaking English was associated with a delay to receiving a first Pap test after migration.

CONCLUSION

The clients at our centre are demographically similar to women who are typically overlooked for Pap tests in the greater Toronto area. Despite belonging to a high-risk population, refugee women in this multidisciplinary CHC were screened for cervical cancer at a higher rate than the local population.