title: Cervical cancer screening among vulnerable women: factors affecting guideline adherence at a community health centre in Toronto, Ont.
abstract: OBJECTIVE
  To see if refugee women at a community health centre (CHC) in Toronto, Ont, are appropriately screened for cervical cancer and if there are any demographic characteristics that affect whether they are screened.
  
  
  METHODS
  Chart review.
  
  
  METHODS
  A CHC in downtown Toronto.
  
  
  METHODS
  A total of 357 eligible refugee women attending the CHC.
  
  
  METHODS
  Papanicolaou test received or documented reason for no Pap test.
  
  
  RESULTS
  Ninety-two percent of women in the study sample were either appropriately screened for cervical cancer or had been approached for screening. Eighty percent of women were appropriately screened. Demographic variables including pregnancy, being uninsured, not speaking English, recent migration to Canada, and being a visible minority did not affect receipt of a Pap test after migration in multivariate analyses. Not speaking English was associated with a delay to receiving a first Pap test after migration.
  
  
  CONCLUSIONS
  The clients at our centre are demographically similar to women who are typically overlooked for Pap tests in the greater Toronto area. Despite belonging to a high-risk population, refugee women in this multidisciplinary CHC were screened for cervical cancer at a higher rate than the local population.
authors.affiliation: Department of Family and Community Medicine, University of Toronto, 263 McCaul St, 5th Floor, Toronto, ON M5T 1W7. meiling.wiedmeyer@utoronto.ca
authors.forename: Mei-ling
authors.initials: ML
authors.lastname: Wiedmeyer
authors.forename: Aisha
authors.initials: A
authors.lastname: Lofters
authors.forename: Meb
authors.initials: M
authors.lastname: Rashid
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003151:Community Health Centers / Q000458:organization & administration / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D017057:Medically Uninsured; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario; D065006:Papanicolaou Test; D017410:Practice Guidelines as Topic; D016016:Proportional Hazards Models; D012036:Refugees; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult