In a recent study published in the journal PLOS One, a team of researchers was able to determine various factors that could explain why Danish and Norwegian immigrant women postpone their attendance for cervical screening in Sweden.
Cervical screening has the capacity to detect and treat at an early stage asymptomatic pre-invasive lesions, and its introduction has led to a decline in cervical cancer incidence and mortality both in Sweden and across Europe. The recommended overall coverage of cervical screening is 85%. However, overall coverage in the country is currently below 80%.
Besides Finland, most female immigrants in Sweden are from Denmark or Norway and have a relative risk of cervical cancer of 80% and 70%, respectively, compared to native-women. Only 47% and 44% of eligible Danish and Norwegian immigrant women follow the national recommendations for attendance at cervical screening, compared to 62% of Swedish-born women.
Sweden and Denmark have a long history of organised cervical screening since population-based screening programmes started in the 1960s. In Norway screening was only introduced in 1994. Consequently the reduction in cervical cancer incidence and mortality has been slower in Norway compared to Denmark and Sweden.
To understand how Danish and Norwegian immigrant women in Sweden reason about attending cervical screening, in the study titled “When Life Got in the Way: How Danish and Norwegian Immigrant Women in Sweden Reason about Cervical Screening and Why They Postpone Attendance”, Fatima Azerkan from the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet in Stockholm, Sweden and colleagues conducted eight focus group discussions (FGDs) with Danish and Norwegian immigrant women living in Stockholm.
To assess participants, researchers used a FGD guide which included questions related to cervical screening and obstacles and motivators to attend cervical screening. Using content analysis the researchers found that the main theme was “Women have a comprehensive rationale for postponing cervical screening, yet do not view themselves as non-attenders”.
Investigation of women’s rationale for non-attendance after being invited to cervical screening showed that the reasons were related to the immigration itself, including competing needs, organisational and structural factors and differences in mentality, but also reasons stemming from other factors. Postponing attendance at cervical screening was the category that linked all these factors, explaining why women did not attend cervical screening.
According to the authors these results corroborate previous knowledge and expertise on immigrant women attendance at cervical screening and provide an insight and greater understanding of how immigrant women perceive attendance at cervical screening in Sweden, along with the challenges they face.