María Barrera-Castillo1, Rosario Fernández-Peña2, María Del Olivo Del Valle-Gómez3, Ana Fernández-Feito3, Alberto Lana4. 1. Centro de Salud de Sabugo, Servicio de Salud del Principado de Asturias, Avilés, España. 2. Departamento de Enfermería, Facultad de Enfermería, Universidad de Cantabria, Santander, España; Grupo de Investigación SALBIS, León, España; Grupo de Investigación en Enfermería IDIVAL, Santander, España. 3. Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo/ISPA, Oviedo, España. 4. Grupo de Investigación SALBIS, León, España; Departamento de Medicina, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo/ISPA, Oviedo, España. Electronic address: lanaalberto@uniovi.es.
Abstract
OBJECTIVE: To explore the association between immigrant status and performance of pap-smear and mammography, and to study the potential effect of social integration on that association. METHOD: Secondary analysis of the National Health Survey of Spain 2012. Individual data from 8944 women aged 18-75 were analyzed. Dependent variables were the performance of pap-smear tests and mammographies according to the guidelines of the state of residence. The level of integration in Spain was estimated through perceived social support (Duke-UNC scale) and the number of years living in Spain. Logistic regressions were used in order to obtain odds ratios (OR) and their 95% confidence intervals (95%CI), adjusted for confounders (sociodemographic and health-status). RESULTS: Compared to natives, immigrant women were more likely to not adhere to cervical cancer screening (OR: 1.31; 95%CI: 1.06-1.63) or breast cancer screening (OR:=3.13; 95%CI: 2.14-4.58). Additional adjustment by social support and length of residence in Spain attenuated the association, consequently losing statistical significance (OR: 1.08, 95%CI: .77-1.52 for pap-smear; OR: 1.62, 95%CI: .97-2.74 for mammographies). CONCLUSIONS: The probability of participating in the screening programs for gynecological cancer was lower if women were born abroad. Perceived social support and time living in Spain of immigrant women explained to a large extent the differences between immigrants and natives.
OBJECTIVE: To explore the association between immigrant status and performance of pap-smear and mammography, and to study the potential effect of social integration on that association. METHOD: Secondary analysis of the National Health Survey of Spain 2012. Individual data from 8944 women aged 18-75 were analyzed. Dependent variables were the performance of pap-smear tests and mammographies according to the guidelines of the state of residence. The level of integration in Spain was estimated through perceived social support (Duke-UNC scale) and the number of years living in Spain. Logistic regressions were used in order to obtain odds ratios (OR) and their 95% confidence intervals (95%CI), adjusted for confounders (sociodemographic and health-status). RESULTS: Compared to natives, immigrant women were more likely to not adhere to cervical cancer screening (OR: 1.31; 95%CI: 1.06-1.63) or breast cancer screening (OR:=3.13; 95%CI: 2.14-4.58). Additional adjustment by social support and length of residence in Spain attenuated the association, consequently losing statistical significance (OR: 1.08, 95%CI: .77-1.52 for pap-smear; OR: 1.62, 95%CI: .97-2.74 for mammographies). CONCLUSIONS: The probability of participating in the screening programs for gynecological cancer was lower if women were born abroad. Perceived social support and time living in Spain of immigrant women explained to a large extent the differences between immigrants and natives.
Keywords:
Breast neoplasms; Community integration; Cribado masivo; Detección precoz del cáncer; Early detection of cancer; Emigrantes e inmigrantes; Emigrants and immigrants; Integración en la comunidad; Mammography; Mamografía; Mass screening; National health programmes; Neoplasias de la mama; Neoplasias uterinas; Programas nacionales de salud; Salud de la mujer; Uterine neoplasms; Women's health
Authors: Adriana Oliva-Arocas; Pamela Pereyra-Zamora; José M Copete; Carlos Vergara-Hernández; Miguel A Martínez-Beneito; Andreu Nolasco Journal: Int J Environ Res Public Health Date: 2020-06-29 Impact factor: 3.390