title: Factors associated with cervical cancer screening participation among immigrants of Russian, Somali and Kurdish origin: a population-based study in Finland.
abstract: Previous studies revealed low participation in cervical cancer screening among immigrants compared with non-immigrants. Only a few studies about factors associated with immigrants' lower participation rates have been conducted in European countries that have universal access for all eligible women. Our study aimed to explore factors associated with cervical screening participation among women of Russian, Somali, and Kurdish origin in Finland.
  
  
  
  We used data from the Migrant Health and Well-being Survey, 2010-2012. Structured face-to-face interviews of groups of immigrants aged 25-60 yielded 620 responses concerning screening participation in the previous five years. Statistical analysis employed logistic regression.
  
  
  
  The age-adjusted participation rates were as follows: among women of Russian origin 73.9% (95% CI 68.1-79.7), for Somalis 34.7% (95% CI 26.4-43.0), and for Kurds 61.3% (95% CI 55.0-67.7). Multiple logistic regressions showed that the most significant factor increasing the likelihood of screening participation among all groups was having had at least one gynecological check-up in the previous five years (Odds ratio [OR] = 6.54-26.2; p < 0.001). Other factors were higher education (OR = 2.63; p = 0.014), being employed (OR = 4.31; p = 0.007), and having given birth (OR = 9.34; p = 0.014), among Kurds; and literacy in Finnish/Swedish (OR = 3.63; p = 0.003) among Russians.
  
  
  
  Our results demonstrate that women who refrain from using reproductive health services, those who are unemployed and less educated, as well as those with poor language proficiency, might need more information on the importance of screening participation. Primary and occupational healthcare services may have a significant role in informing immigrant women about this importance.
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 7021, Kuopio, Finland. estheri@uef.fi.|Department of Public Health, University of Helsinki, Helsinki, Finland. estheri@uef.fi.
authors.forename: Esther E
authors.initials: EE
authors.lastname: Idehen
authors.affiliation: Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistoranta 1, P. O. Box 1627, 7021, Kuopio, Finland.|Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Tellervo
authors.initials: T
authors.lastname: Korhonen
authors.affiliation: Department of Welfare, Equality and Inclusion Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.
authors.forename: Anu
authors.initials: A
authors.lastname: Castaneda
authors.affiliation: Department of Welfare, Equality and Inclusion Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.
authors.forename: Teppo
authors.initials: T
authors.lastname: Juntunen
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
authors.forename: Mari
authors.initials: M
authors.lastname: Kangasniemi
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
authors.forename: Anna-Maija
authors.initials: AM
authors.lastname: Pietilä
authors.affiliation: Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland.
authors.forename: Päivikki
authors.initials: P
authors.lastname: Koponen
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000208:ethnology; D006801:Humans; D007492:Iran / Q000208:ethnology; D007493:Iraq / Q000208:ethnology; D016015:Logistic Models; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D012426:Russia / Q000208:ethnology; D012998:Somalia / Q000208:ethnology; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000523:psychology
keywords: Cervical cancer; Early detection; Finland; Immigrants; Pap test; Screening participation