Abstract
Background
Several studies have shown that immigrants attend mammographic screening less frequently than non-immigrants. Studies have also shown that attendance is influenced by socio-demographic factors. We aimed to describe the relationship between socio-demographic factors and first attendance among immigrant and non-immigrant women invited to BreastScreen Norway.
Methods
Our cohort consisted of 885,979 women invited to BreastScreen Norway for their first time between 1996 and 2015. We merged individual-level socio-demographic data to attendance data corresponding to women’s first invitation to the program. Using Poisson regression, we calculated rate ratios with 95% confidence intervals (95% CI) for attendance, stratified by region of origin. Covariates of interest included age, income, education level, employment status, marital status, citizenship and years since immigration, among others.
Results
Fifty-three percent of immigrants and 76% of non-immigrants attended mammographic screening after their first invitation; immigrants as a whole had lower attendance rates across all socio-demographic factors. However, the association between socio-demographic factors and attendance varied between immigrant groups. For all immigrants, no recorded education demonstrated the strongest association with non-attendance compared with ≤ 10 years recorded education (RRadj: 0.69, 95% CI: 0.67–0.71). Other factors associated with non-attendance were low income, living in Oslo, not being employed and being a recent immigrant.
Conclusion
The association between socio-demographic factors and mammographic screening attendance differed between immigrant groups. Further studies and preventive health measures should take into account that considering immigrants as a homogeneous group may lead to less effective interventions.
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Acknowledgements
This study was supported by a grant from the Norwegian Breast Cancer Society, funded by the Norwegian ExtraFoundation for Health and Rehabilitation (2016/FO76429) (https://www.extrastiftelsen.no/logo/). The funding source had no involvement in the conduction of the study, interpretation of the results or preparation of the manuscript.
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The Regional Committees for Medical and Health Research Ethics (REC 2013/795) approved this study.
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Le, M., Hofvind, S., Tsuruda, K. et al. Lower attendance rates in BreastScreen Norway among immigrants across all levels of socio-demographic factors: a population-based study. J Public Health (Berl.) 27, 229–240 (2019). https://doi.org/10.1007/s10389-018-0937-1
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DOI: https://doi.org/10.1007/s10389-018-0937-1