ImmigrantScreen

This project will examine the effect on attendance of using the assumed mother tongue as the language of cancer screening invitation and information in immigrant groups, as well as investigate reasons why immigrants attend or not in organized screening for colorectal cancer.
Last updated: 12/1/2022

Background and purpose

In Norway, all women between the ages of 50 and 69 are invited every other year to BreastScreen Norway, which is a population-based screening program for breast cancer in Norway. A national screening program for colorectal cancer - ColorectalScreen Norway - will be rolled out in 2022/2023. 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 receiving invitations and information about breast and colorectal cancer screening in the presumed mother tongue of immigrant groups in addition to in Norwegian, will affect attendance rates among the 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 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 in Norwegian is compared with attendance among those who have only received invitations in Norwegian.

Status: Ongoing. Participants were recruited between April 2021 and August 2022. Analyzes of data and writing of an article is ongoing. 

Study 2: A qualitative study that will investigate factors that may influence attendance in colorectal cancer screening among immigrants born in Poland and Pakistan.

Status: Ongoing. The study about immigrants born in Poland is published; Polish immigrants' access to colorectal cancer screening in Norway - a qualitative study. Bhargava S. et al, BMC Health Serv Res. 2022 Nov, doi: 10.1186/s12913-022-08719-3. We are planning to conduct interviews with immigrants born in Pakistan in spring 2023.

Study 3: A randomized controlled trial that will investigate whether oral information about colorectal cancer screening in the presumed mother tongue will increase attendance among immigrants in ColorectalScreen Norway. Status: Not started. Necessary approvals have been obtained.

Data

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 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: We conduct thematic analyses of qualitative interviews with immigrants aged 50 to 60 born in Poland and Pakistan. The interviews are semi-structured and carried out in Polish, Urdu or Norwegian.

Study 3: Information about data included in Study 3 will be presented closer to the start-up of the study.

Organization

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.