Background and purpose
In Norway, all women between the ages of 50 and 69 are invited every other year to BreastScreen Norway, which is the public screening program for breast cancer in Norway. A national screening program for colorectal cancer - ColorectalScreen Norway - is scheduled to start in the autumn of 2021. Here, all women and men will be invited to participate during the year they turn 55.
The aim of breast and colorectal cancer screening is to detect early stage cancers or precursors of cancer, in order to reduce deaths due to these diseases. Studies from Norway and other countries have shown that immigrants have lower attendance rates in cancer screening than non-immigrants. The reasons are probably complex, and can be linked to - among other things - socio-economic factors, barriers related to communication and pre- and post-migration factors.
The Cancer Registry of Norway has therefore started ImmigrantScreen as a collaborative project between BreastScreen Norway and CorerectalScreen Norway. The purpose is to investigate whether sending an invitation to breast and colorectal cancer screening in the presumed mother tongue, in addition to in Norwegian, will affect attendance rates among immigrants. The project will also investigate which factors may influence immigrant women and men's decision to attend in ColorectalScreen Norway. Similar studies related to breast cancer screening have been carried out earlier in a doctoral project in BreastScreen Norway.
Sub-studies and status
Study 1: A randomized controlled trial that will investigate whether receiving an invitation in one's mother tongue, in addition to in Norwegian, will affect immigrant women´s participation in BreastScreen Norway.
In the analyzes, attendance among those who have received invitations both in their presumed mother tongue and Norwegian will be compared with attendance among those who have only received invitations in Norwegian.
Status: Necessary approvals have been obtained. The IT-systems in BreastScreen Norway have bee adjusted, to be able to send out invitations in multiple languages. Two pilot studies were carried out in the period December 2020 - March 2021. In April 2021, the study and data collection started as the first invitation letters were sent out in BreastScreen Norway.
Study 2: A qualitative study that will investigate factors that can facilitate or prevent attendance in colorectal cancer screening among immigrants with Pakistani and Polish backgrounds. Status: Not started. Necessary approvals have been obtained.
Study 3: A randomized controlled trial that will investigate whether invitation letters in the presumed mother tongue, in addition to in Norwegian, will increase attendance in ColorectalScreen Norway compared with invitations only in Norwegian. Status: Not started. Necessary approvals have been obtained.
Study 1: The study will use information from the Cancer Registry's databases, in accordance with the Cancer Registry Regulations. We will use information about country of birth, and about invitation and attendance in BreastScreen Norway. The study population is women aged 50-69 who are invited to participate in BreastScreen Norway, and who are registered with their country of birth in either Algeria, Egypt, the Philippines, Iraq, Lebanon, Morocco, Pakistan, Palestine, Poland, Somalia, Sudan, Syria or Tunisia.
This project will only use data from women who have not refused permanent storage in the Cancer Registry of Norway of personal data related to normal screening examinations. It will be impossible to recognize individuals in published results.
Study 2 and 3: Information about data included in Study 2 and 3 will be presented closer to the start-up of these studies.
The Cancer Registry of Norway is data controller in the project. We are responsible for obtaining the necessary approvals, collecting and analyzing the data, and publishing results.