title: Participation and risk of high grade cytological lesions among immigrants and Italian-born women in an organized cervical cancer screening program in Central Italy.
abstract: Few studies analyzed the risk for high-grade squamous intraepithelial lesions or worse (HSIL+) among immigrants and natives attending organized cervical cancer (CC) screening programs (SP). We evaluated participation and diagnosis of HSIL+ by country of birth with logistic models. Overall 540,779 invitation letters were delivered to target women of Florence SP in three screening rounds (years 2000-2002, 2003-2005, 2006-2008). The probability of attending screening was lower for immigrants than natives, but the difference decreased from 35% (1st round) to 20% (2nd-3rd round) for women born in high migration pressure (HMP) countries. The risk of HSIL+ was double than natives for HMP-born women from countries with high prevalence of human papillomavirus, even adjusting for age and previous history of Pap test. This is an important public health problem due to an increasing proportion over time of immigrant women with a lower attendance and greater risk for CC.
authors.affiliation: Clinical and Descriptive Epidemiology Unit, ISPO - Istituto per lo Studio e la Prevenzione Oncologica, Via delle Oblate 2, 50144, Florence, Italy, latorre.visioli2@teletu.it.
authors.forename: Carmen Beatriz
authors.initials: CB
authors.lastname: Visioli
authors.forename: Emanuele
authors.initials: E
authors.lastname: Crocetti
authors.forename: Marco
authors.initials: M
authors.lastname: Zappa
authors.forename: Anna
authors.initials: A
authors.lastname: Iossa
authors.forename: Karin Louise
authors.initials: KL
authors.lastname: Andersson
authors.forename: Paolo
authors.initials: P
authors.lastname: Bulgaresi
authors.forename: Antonia
authors.initials: A
authors.lastname: Alfieri
authors.forename: Gianni
authors.initials: G
authors.lastname: Amunni
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology