Impact of geographic origin on gynecological cancer screening in Spain

OBJECTIVE: To assess the association between geographic origin and the use of screening cervical smears and mammograms. METHODS: Data was obtained from the 2006 Spanish National Health Survey that included 13,422 females over 16 years of age. The dependent variable was use of screening mammograms and cervical smears in the past 12 months. The measure of association (odds ratio and its related 95% confidence interval) was estimated using logistic regression. RESULTS: African women were 0.36 (95% CI 0.21,0.62), Eastern European 0.40 (95% CI 0.22; 0.74), Western European, American and Canadian 0.60 (95% CI 0.43,0.84), and Central and South American 0.64 times (95% CI 0.52, 0.81) less likely to undergo a mammogram compared with the general population of Spain. In regard to cervical cancer screening, Eastern European women were 0.38 (95% CI 0.28,0.50), African 0.47 (95% CI 0.33,0.67) and Western European, American and Canadian 0.61 times (95% CI 0.46, 0.81) less likely to undergo cervical smears. These associations were independent of age, socioeconomic condition, health status and health insurance coverage. CONCLUSIONS: Immigrant women use less screening programs than native Spanish women. This finding may suggest difficult access to prevention programs.