Alexander Bischoff, Marina Fontana, Philippe Wanner, Ursula Greuter
Cervical cancer screening is cost-effective and reduces both the incidence and mortality of cervical cancer. This study examined variability in the selfreported use of the Papanicolaou (Pap) test among women from six immigrant groups living in Switzerland, a country with an immigrant population of 20.5%. This study is a secondary analysis of data from the 2002 Swiss Health Survey, a nationwide crosssectional telephone survey. Descriptive statistical and multivariate analyses were performed to describe the demographic characteristics of a subsample (n = 9385). The dichotomous variable of interest was Pap smear, and the main independent variable was immigrant group. We adjusted for socio-demographic factors and used logistic regression, with Swiss women as the comparison group. ‘Immigrant group’ also included people of foreign nationality who were born in Switzerland. The main factors that predicted uptake of the Pap smear were higher income, older age and nationality. Women in five of the six immigrant groups that were analysed were less likely to be screened than Swiss women. Women from Portugal (OR = 4.29), the former Yugoslavia (OR = 2.45), France (OR = 1.96), Spain (OR = 1.79) and Italy (OR 1.53) more frequently said that they had not been tested by a Pap smear comparedwith women from Switzerland (P = 0.001). Only German women were more likely to have been screened than Swiss women (OR of being untested = 0.29). There is significant variability in the uptake of cervical cancer screening among six of the immigrant groups living in Switzerland. A systematic cervical cancer screening programme tailored to the immigrant group profiles would benefit immigrant women and would be an important step towards equity of access to healthcare.
