Cervical cancer screening among foreign-born women by birthplace and duration in the United States

Objective: Mortality rates for cervical cancer have increased among foreign-born women in the United States in the last two decades. Previous research indicates that rates of Pap testing are lower among foreign-born women than in U.S.-born women. This study identifies screening rates among foreign-born women by birthplace and duration in the United States. Methods: We used data from 4 years (1998, 1999, 2000, 2003) of the National Health Interview Survey (NHIS) to estimate Pap testing rates by birthplace (Mexico, Central America, Caribbean, South America, Europe, Russia, Africa, Middle East, India, Asia, and Southeast Asia) and percent of lifetime spent in the United States for women aged >= 18 years (n = 70,775). Rates were age standardized to the 2000 U. S. population. Results: After adjusting for demographic characteristics and health indicators, we found that 18.6% (95% CI 16.7, 20.6) of recent immigrants (<25% of lifetime in the United States) and 9.9% (95% CI 9.0, 10.8) of established immigrants (>= 25% of lifetime in the United States) never received a Pap test in their lifetime compared with 5.8% (95% CI 5.5, 6.1) of U.S.-born women. Adjusted prevalence of never receiving a Pap test was highest among women from Asia, Southeast Asia, and India (19.6%), South America (12.7%), Mexico (11.2%), Caribbean (11.0%), Europe (9.9%), and Central America (9.2%). Conclusions: Significant differences exist in rates of screening for cervical cancer between foreign-born groups by birthplace and by duration in the United States. Nationally and locally funded screening programs may benefit from these findings in developing screening strategies for foreign-born women.