Immigrant women less often attend mammography screening

Published 08.11.2017

"Mammography screening should be offered to everyone, regardless of income, place of residence and country of birth. This study shows large differences in admission rates to mammography screening based on country of birth. We need to explore these differences further, and investigate whether there are special factors that prevent immigrant women from accessing mammography screening," says Sameer Bhargava, doctor and PhD candidate at the Cancer Registry.

He has mapped immigrant women's participation in the Mammography Programme, and the results show marked variations in attendance, according to where the women originally come from. This is the first time such a survey has been conducted using figures from the Norwegian Mammography Programme.

The study was conducted with funding from the Extra Foundation and support from the Breast Cancer Society.

86 per cent of Norwegian women who received an invitation for screening participated at least once inthe period from 1996 to 2015, while only 67 per cent of immigrant women attended.

The figure shows a sample of the immigrant groups and their participation in the Mammography Programme. 86 per cent of the invited Norwegian women have participated at least once, while 42 per cent of the women from Baltic countries have participated.

Few women from Somalia participate

"Women from Somalia have by far the lowest participation, with only one in four of those invited having ever participated in the programme. They also have the lowest attendance regardless of whether we look at the first invitation received, all invitations received, or whether the women have ever been to screening," says Sameer Bhargava.

Among women from the Baltic countries and North and East African countries, around half have never participated in the Norwegian Mammography Programme, according to the new study, which was recently published in the European Journal of Public Health.

Although these have the lowest participation, there are also many others who rarely attend mammography screening.

"Women with low attendance come from many different countries. A list of the 10 countries of birth of women with the lowest attendance includes countries in Europe, Asia and Africa, Bhargava said.

The difference in attendance between Norwegian women and immigrant women remained large overall, even after taking into account sociodemographic factors, i.e. factors such as income and education.

The attendance among immigrants increased with the number of years in Norway, but no immigrant groups reach the level for Norwegian women. Those who approach the most are women from other Nordic countries. Of these, 80 per cent of those invited have met at least once.

Children of immigrants had a higher turnout than those who moved to the country, but still lower than other Norwegian women.

Invites everyone between the ages of 50 and 69

The Norwegian Mammography Programme offers breast cancer screening with mammography to women aged 50-69 every two years, with the aim of detecting breast cancer at an early stage.

Prior to this study, there was no overview of immigrant women's attendance for breast cancer screening in Norway.

The Cancer Registry of Norway has examined immigrant women's attendance at breast cancer screening compared with the rest of the population over the age of 20, from the programme's inception in 1996 to 2015.

Solveig Hofvind, head of the Mammography Programme, says that this is important insight.

"This study gives us knowledge about a topic we have long struggled to understand. Now we know with certainty that a very low proportion of immigrant women attend screening," she says, but emphasizes that there is still much left to find out.

"Now we need to find out why this is so, and whether there are special factors that exclude immigrant women from accessing mammography screening – and not least what we can do to give immigrants a better basis for making an informed choice, so they can decide whether they want to participate," she says.

The first Mammography Programme will investigate further is whether there are differences by counties and sociodemographic factors, such as income and employment status, and then how immigrant women fare compared with Norwegian-born women.

"This is very important in order to adapt and adapt the Mammography Programme to today's needs," Hofvind emphasizes.