title: Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study.
abstract: South Asian (SA) immigrants settled in the United Kingdom (UK) and North America [United States (US) and Canada] have low screening rates for breast, cervical and colorectal cancers. Incidence rates of these cancers increase among SA immigrants after migration, becoming similar to rates in non-Asian native populations. However, there are disparities in cancer screening, with low cancer screening uptake in this population. We conducted a scoping study using Arksey & O'Malley's framework to examine cancer screening literature on SA immigrants residing in the UK, US and Canada. Eight electronic databases, key journals and reference lists were searched for English language studies and reports. Of 1465 identified references, 70 studies from 1994 to November 2014 were included: 63% on breast or cervical cancer screening or both; 10% examined colorectal cancer screening only; 16% explored health promotion/service provision; 8% studied breast, cervical and colorectal cancer screening; and 3% examined breast and colorectal cancer screening. A thematic analysis uncovered four dominant themes: (i) beliefs and attitudes towards cancer and screening included centrality of family, holistic healthcare, fatalism, screening as unnecessary and emotion-laden perceptions; (ii) lack of knowledge of cancer and screening related to not having heard about cancer and its causes, or lack of awareness of screening, its rationale and/or how to access services; (iii) barriers to access including individual and structural barriers; and (iv) gender differences in screening uptake and their associated factors. Findings offer insights that can be used to develop culturally sensitive interventions to minimise barriers and increase cancer screening uptake in these communities, while recognising the diversity within the SA culture. Further research is required to address the gap in colorectal cancer screening literature to more fully understand SA immigrants' perspectives, as well as research to better understand gender-specific factors that influence screening uptake.
authors.affiliation: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.|Department of Nursing, Brock University, St. Catharines, Ontario, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Crawford
authors.affiliation: School of Health Policy and Management, Faculty of Health, York University, Toronto, Ontario, Canada.
authors.forename: Farah
authors.initials: F
authors.lastname: Ahmad
authors.affiliation: Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.|Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.|Measurement Stream, Institute for Work & Health, Toronto, Ontario, Canada.
authors.forename: Dorcas
authors.initials: D
authors.lastname: Beaton
authors.affiliation: Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.|Lawrence S. Bloomberg Faculty of Nursing, Institute of Health Policy, Management and Evaluation, Department of Medicine and Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Arlene S
authors.initials: AS
authors.lastname: Bierman
mesh_terms: D001208:Asia / Q000208:ethnology; D002170:Canada; D055088:Early Detection of Cancer; D054242:Emigrants and Immigrants; D006801:Humans; D008403:Mass Screening; D010342:Patient Acceptance of Health Care; D006113:United Kingdom; D014481:United States
keywords: South Asian; access to healthcare; cancer prevention and control; ethnic minorities; ethnicity and health; screening