XXXX screening disparities among urban immigrants: a population-based study in Ontario, Canada.

@entity1 @entity258 @entity0
BACKGROUND: @entity0 is one of the leading cause of mortality and morbidity in Canada. Screening is the most promising approach in identification and treatment of the disease at early stage of its development. Research shows higher rate of @entity0 mortality among ethno-racial immigrant @entity1 despite their lower incidence which suggests disparities in mammography screening. This study aimed to compare the prevalence of appropriate mammography screening among immigrant and native borne @entity1 and determine predicators of low mammography screening. METHODS: We conducted secondary data analyses on Ontario linked social and health databases to determine the proportion of @entity1 who were screened during the two-year period of 2010-2012 among 1.4 million screening-eligible @entity1 living in urban centres in Ontario. We used multivariate Poisson regression to adjust for various socio-demographic, health care-related and migration related variables. RESULTS: 64% of eligible @entity1 were appropriately screened. Screening rates were lowest among new and recent immigrants compared to referent group (Canadian-born @entity1 and immigrant who arrived before 1985) (Adjusted Rate Ratio (ARR) (0.87, 95% CI 0.85-0.88 for new immigrants and 0.90, 95% CI 0.89-0.91 for recent immigrants. Factors that were associated with lower rates of screening included living in @entity258 , having a male physician, having internationally-trained physician and not being enrolled in primary care @entity1 enrolment models. Those not enrolled were 22% less likely to be screened compared to those who were (ARR 0.78, 95% CI 0.77-0.79). CONCLUSION: To enhance immigrant @entity1 screening rates efforts should made to increase their access to primary care @entity1 enrolment models and preferably female health professionals. Support should be provided to interventions that address screening barriers like language, acculturation limitations and knowledge deficit. Health professionals need to be educated and take an active role in offering screening guidelines during health encounters.
