title: The pattern of cervical smear abnormalities in marginalised women in Hong Kong.
abstract: BACKGROUND
  "Ripple Action" and "WE Stand" are projects co-organised by the Hong Kong Women Doctors Association. The two projects organise free cervical screening for low-income women, new immigrants from Mainland China, and ethnic minority women. The objective of this study was to analyse the pattern of cervical smear abnormalities in these marginalised women.
  
  
  METHODS
  The study group consisted of 1189 marginalised women who participated in a free cervical screening campaign, including 324 low-income local Chinese, 540 new immigrants from Mainland China, and 325 ethnic minority women. The comparison group consisted of 1141 local Chinese who attended a well women clinic. The prevalence of cervical smear abnormalities was compared using Chi squared test.
  
  
  RESULTS
  In the study group, 42.6% of women had never had a cervical smear. Compared with the comparison group, they had a significantly higher prevalence of cervical smear abnormalities (13.7% vs 1.4%; P<0.001), including atypical smear (10.8% vs 0.5%; P<0.001), low-grade lesion (1.8% vs 0.8%; P=0.036), and high-grade lesion (1.1% vs 0.1%; P=0.002). Logistic regression analysis showed that the strongest predictors for abnormal cervical smear were being South Asian (odds ratio=11.859; 95% confidence interval, 4.635-30.341), South-East Asian (6.484; 3.192-13.171), or new immigrant from Mainland China (6.253; 2.463-15.877).
  
  
  CONCLUSIONS
  Marginalised women had a significantly higher prevalence of cervical smear abnormality than the general population and almost half had never had a cervical smear before. Outreach strategies are needed to enrol this population into screening programmes.
authors.affiliation: Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Y H
authors.initials: YH
authors.lastname: Ting
authors.affiliation: Magnus MRI and Ultrasound Diagnostic Center, Hermes Commercial Centre, Tsimshatsui, Hong Kong.
authors.forename: H Y
authors.initials: HY
authors.lastname: Tse
authors.affiliation: Department of Obstetrics and Gynaecology, Tseung Kwan O Hospital, Tseung Kwan O, Hong Kong.
authors.forename: W C
authors.initials: WC
authors.lastname: Lam
authors.affiliation: Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Yaumatei, Hong Kong.
authors.forename: K S
authors.initials: KS
authors.lastname: Chan
authors.affiliation: Well Women Clinic, Tung Wah Group of Hospitals, Yaumatei, Hong Kong.
authors.forename: T Y
authors.initials: TY
authors.lastname: Leung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Papillomavirus infections; Uterine cervical neoplasms; Women’s rights