Simone Kaucher1, Laura Khil2, Hiltraud Kajüter2, Heiko Becher3,4, Maren Reder5,6, Petra Kolip6, Jacob Spallek7, Volker Winkler3, Eva-Maria Berens8. 1. Unit of Epidemiology & Biostatistics, Institute of Global Health, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany. simone.kaucher@uni-heidelberg.de. 2. Federal Cancer Registry of North Rhine-Westphalia, Bochum, Germany. 3. Unit of Epidemiology & Biostatistics, Institute of Global Health, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany. 4. Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 5. Institute of Psychology, University of Hildesheim, Hildesheim, Germany. 6. Department of Prevention and Health Promotion, Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany. 7. Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany. 8. Department of Health Services Research and Nursing Science, Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany.
Abstract
BACKGROUND: European studies showed that women with a migration background are less likely to participate in mammography screenings than autochthonous women. However, the participation in the German mammography screening programme (MSP) among ethnic German migrants from countries of the former Soviet Union (called resettlers) is unclear so far. The aim of this study was to identify possible differences regarding MSP participation between resettlers from the FSU and the general German population. METHODS: Data from two independent, complementary studies from North Rhine-Westphalia, Germany (a retrospective cohort study 1994-2013; a cross-sectional study 2013/14) were used for comparisons between resettlers and the general population: Odds Ratios (ORs) for MSP participation utilizing the cross-sectional data and time trends of breast cancer incidence rates as well as Chi-Square tests for breast cancer stages utilizing the cohort data. RESULTS: Resettlers showed higher Odds to participate in the MSP than the general population (OR 2.42, 95% CI 1.08-5.42). Among resettlers, a large increase in incidence rates was observed during the MSP implementation (2005-2009), resulting in stable and comparable incidence rates after the implementation. Furthermore, pre-MSP implementation, the proportion of advanced breast cancer stages was higher among resettlers than in the German population, post-MSP implementation the proportion was comparable. CONCLUSIONS: MSP participating seems surprisingly high among resettlers. An explanation for the increased willingness to participate might be the structured invitation procedure of the MSP. However, the exact reasons remain unclear and future research is needed to confirm this hypothesis and rule out the possibility of selection bias in the cross-sectional study.
BACKGROUND: European studies showed that women with a migration background are less likely to participate in mammography screenings than autochthonous women. However, the participation in the German mammography screening programme (MSP) among ethnic German migrants from countries of the former Soviet Union (called resettlers) is unclear so far. The aim of this study was to identify possible differences regarding MSP participation between resettlers from the FSU and the general German population. METHODS: Data from two independent, complementary studies from North Rhine-Westphalia, Germany (a retrospective cohort study 1994-2013; a cross-sectional study 2013/14) were used for comparisons between resettlers and the general population: Odds Ratios (ORs) for MSP participation utilizing the cross-sectional data and time trends of breast cancer incidence rates as well as Chi-Square tests for breast cancer stages utilizing the cohort data. RESULTS: Resettlers showed higher Odds to participate in the MSP than the general population (OR 2.42, 95% CI 1.08-5.42). Among resettlers, a large increase in incidence rates was observed during the MSP implementation (2005-2009), resulting in stable and comparable incidence rates after the implementation. Furthermore, pre-MSP implementation, the proportion of advanced breast cancer stages was higher among resettlers than in the German population, post-MSP implementation the proportion was comparable. CONCLUSIONS: MSP participating seems surprisingly high among resettlers. An explanation for the increased willingness to participate might be the structured invitation procedure of the MSP. However, the exact reasons remain unclear and future research is needed to confirm this hypothesis and rule out the possibility of selection bias in the cross-sectional study.
Entities:
Keywords:
Breast cancer; Mammography screening programme; Migrants; Participation; Resettlers; Stage at diagnosis
Authors: Charlotte Arena; Christine Holmberg; Volker Winkler; Philipp Jaehn Journal: Int J Environ Res Public Health Date: 2021-12-24 Impact factor: 3.390