Identifying Barriers To Cervical Cancer Screening Among South Asian Muslim Immigrant Women

Syeda RIZVI, University of Calgary, Canada
RIZVI S. 1 , HEBERT M. 1 , THOMAS B. 3 , DICKINSON J. 2

1 Department of Community Health Sciences, University of Calgary, Calgary, Canada
2 Department of Family Medicine & Community Health Sciences, University of Calgary, Calgary, Canada
3 Department of Oncology, Cumming School Of Medicine, University of Calgary, Calgary AB, Canada

Objectives: We sought to identify the barriers to cervical cancer screening among South Asian Muslim immigrant women in Calgary. Understanding their ideas and needs will enable development of educational programs and services so they can benefit from screening and reduce the effect of this disease.

Approach: Qualitative, semi-structured in-depth interviews, by purposive sampling, were conducted with South Asian Muslim immigrant women of Calgary who were unscreened or infrequently screened for cervical cancer. Thematic analysis was conducted for data analysis using Microsoft Word.

Results: 18 women were interviewed and the majority (66%) never had a Pap test. Findings were categorized into five major themes: Attitude, knowledge & beliefs, healthcare seeking practices, experience with healthcare system & services, barriers and strategies to Pap testing. Major findings include: misunderstanding about Pap test reminders, strong preference for a female physician who also speaks their language, seeking symptomatic treatment not prevention, negative experiences with healthcare providers including painful Pap test experience. Major barriers involved: lack of knowledge about cervical cancer and the term cervix, fatalist beliefs, dependence on husband, transportation, language and unavailability of female physicians. Separate centers for Pap testing, awareness and encouragement by social workers and family physicians to get tested were strategies participants suggested.

Conclusion: Different healthcare strategies are needed at the system and provider level to improve healthcare experience of these women and to promote cervical cancer screening. Providing female physicians, knowledge and resources such as transportation and a separate center, and screening reminders that explain the procedure and the disease in detail could potentially increase screening practices.