Access and utilisation of cervical cancer screening services

Access and utilisation of cervical cancer screening services among four African immigrant communities in Finland: A qualitative study MERH, 17 -19 May 2018, Edinburgh Esther Idehen MSc 1 Denise Gastaldo Ph. D 2, Anna-Maija Pietilä Ph. D 3, Mari Kangasniemi Ph. D 3 1 Institute of Public Health & Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Finland 2 Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada 3 Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Finland UEF // University of Eastern Finland Research sponsored by Matti and Vappu Maukonen and Saastamoinen Foundations (Esther Idehen)

Background: Cervical cancer Global picture ØGlobally, cervical cancer is a commonly diagnosed cancer in women (GLOBOCAN 2012). ØA considerable decrease in incidence rates of the disease has been observed in most developed countries (WHO, 2017). ØMost cases and about 90% of deaths from cervical cancer were reported in low- and middle-income countries in 2012 (GLOBOCAN 2012). ØIt represents a significant public health challenge. Estimated Cervical Cancer Incidence & Mortality Worldwide Globocan 2012 UEF // University of Eastern Finland MERH, 2018/ Esther Idehen 25. 9. 2020 2

Access and utilisation of cervical cancer screening services ØWorldwide, the migrant population raised to 244 million in 2015, about half (52. 4%) are women, also in Finland (UN 2015, Statistics Finland, 2017). ØStudies reported disparities and low cervical cancer screening participation among some immigrant groups (Idehen E. al. 2017, 2018). ØUnderstanding how different immigrant groups access and utilise the services is imperative. Ø Need to identify groups at risk for the disease. UEF // University of Eastern Finland 25. 9. 2020 MERH 2018/, Esther Idehen 3

Cervical screening The good news …. . ØCervical cancer is a preventable disease (WHO 2014). HOW? Through regular screening by Pap test. Mostly through organised screening programmes Early detection, effective follow-up, and treatment. ØCervical screening and follow-up are recommended for all eligible women (WHO 2013). UEF // University of Eastern Finland MERH 2018/Esther Idehen 25. 9. 2020 4

Cervical screening ØFinland offers free cervical screening age group 3060, depending on the municipality and using a fiveyear interval (Finnish Cancer registry, 2018). ØThe municipality of residence is responsible for sending personal invitation letters to women identified from the national population register (Anttila et al. 2000) ØCost-effective service (Council of the EU 2004). UEF // University of Eastern Finland MERH 2018/Esther Idehen EUCAN 2012(IARC) –(1/6/2014 5

Access and utilisation of cervical cancer screening services Study aims Ø To explore immigrant women’s perceptions and experiences in accessing and utilising screening services. ØFactors that might enable or inhibit access and utilisation of the screening services Methods ØParticipants: Immigrant women of Nigerian, Ghanaian, Cameroonian and Kenyan origin in Finland ØAge: 27 -40 years ØData collection: n: 30 (9 focus groups discussions) ØData analysis: Tape-recorded focus group discussions, transcribed analysed for identification of central themes. UEF // University of Eastern Finland MERH 2018/ Esther Idehen 25. 9. 2020 6

Preliminary results: Cervical cancer screening access and utilisation Facilitating factors to screening access and utilisation üScreening is free ü Screening is for early cancer detection üScreening accessed through reproductive healthcare clinics. Barriers to screening v. Lack of screening awareness v. Limited language skills v. Misunderstanding of screening UEF // University of Eastern Finland MERH 2018/ Esther Idehen 7 25. 9. 2020

Conclusion- Main messages § These preliminary results demonstrate that; v. Adequate screening information and culturally-designed programmes are needed: ØWriting screening invitation letters and information in English, ØCreating screening awareness and information via many channels (organisations centers and social media). ØWomen not using reproductive healthcare services might need more information. üTogether, we can win the war of cervical cancer! UEF // University of Eastern Finland MERH, 2018 /Esther Idehen 25. 9. 2020 8

Thank you! uef. fi Esther Idehen estheri@uef. fi