title: Why many visible minority women in Canada do not participate in cervical cancer screening.
abstract: OBJECTIVE
  To determine a high-risk group of visible minority women in Canada who do not participate in cervical cancer screening and the reasons why they do not participate.
  
  
  METHODS
  We combined two cycles of a large Canadian health survey, Canadian Community Health Survey (CCHS), to obtain a large sample size of visible minority women. Proportions of 'never having a Papanicalaou (Pap) test' and 'not having a Pap test within the last three years' were then calculated for different ethnic groups using sampling weights advised by Statistics Canada to account for the complex sampling procedure used in CCHS. A logistic regression model was developed to test the association between demographic and health-related variables and not having a Pap test. To identify visible minority women who were at a high risk of not having a Pap test, we stratified these women simultaneously on three variables that were significant in the logistic regression model.
  
  
  RESULTS
  Visible minority women were more than twice as likely never to have had a Pap test. Among visible minority women, those who recently immigrated to Canada and did not have a regular physician had the highest risk for not having a Pap test. Common reasons reported for not having a Pap test included believing it was not necessary and simply not getting around to it.
  
  
  CONCLUSIONS
  Visible minority women in Canada may not be participating in regular Pap testing because of cultural beliefs and a lack of an understanding of the importance of Pap testing. A culturally appropriate cervical cancer screening intervention program that involves members of visible minority communities may increase participation of this subgroup of Canadian women. This study provides preliminary information on why visible minority women in Canada do not participate in cervical cancer screening. However, the lumping together of all visible minority may obscure differences between different ethnic groups. Therefore, further research on each ethnic group is required to develop tailored culturally appropriate intervention.
authors.affiliation: Department of Community Health Sciences, Health Canada, First Nations and Inuit Health, Calgary, Alberta, Canada. ernestam@cancerboard.ab.ca
authors.forename: Ernest
authors.initials: E
authors.lastname: Amankwah
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ngwakongnwi
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D002648:Child; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D008913:Minority Groups; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D020379:Risk Adjustment; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult