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Participation in cervical cancer screening among migrants and non-migrants in primary healthcare in Lisbon: a register-based study

Year: 2025

Type: article

Abstract: INTRODUCTION: Cervical cancer screening is a critical preventive measure to reduce the burden of cervical cancer. Yet, disparities persist worldwide, particularly among migrant populations. This study examined cervical cancer screening participation among migrant and non-migrant women enrolled in the primary healthcare centres in the Lisbon district. METHODS: This cross-sectional study analysed healthcare records from 88 278 women aged 25-60 years. Participation was assessed based on documented screening within nationally recommended timeframes. Migrants were classified by nationality into Portuguese-speaking and non-Portuguese-speaking groups. Screening participation was compared between groups, adjusting for age, family doctor assignment, primary healthcare unit type and provider gender. Logistic regression identified factors influencing participation. RESULTS: Migrants showed lower uptake of cervical cancer screening: 19.6% for non-Portuguese-speaking and 31.9% for Portuguese-speaking migrants, compared with 43.7% in non-migrants. After adjusting for confounders, non-Portuguese-speaking migrants had significantly lower odds of participation (OR 0.46, 95% CI 0.43 to 0.50, p<0.01), while Portuguese-speaking migrants had participation rates similar to non-migrants (p=0.29). Key healthcare factors that were associated with higher participation include enrolment in Family Health Units (FHUs) (OR=3.55, 95% CI 3.41 to 3.70, p<0.01) and having an assigned female family doctor (OR 1.43, 95% CI 1.37 to 1.50, p<0.01). CONCLUSIONS: Migrant women face unique barriers to cervical cancer screening, particularly language and cultural differences. These findings highlight the need for tailored screening programmes incorporating multilingual support, cultural mediation and self-sampling for human papillomavirus testing as an alternative screening method. Enhancing healthcare delivery through training, improved access to family doctors and more incentive-driven FHUs could significantly improve screening uptake. Addressing these disparities is crucial for advancing health equity and enhancing cervical cancer prevention.

Source: BMJ Global Health

DOI: 10.1136/bmjgh-2025-019061

Authors: Catarina Gomes Madeira, Claudia Marotta, Anna Georgina Ditter, Mario Carlo Battista Raviglione