Facilitators and Barriers to Cervical Cancer Screening Among Chinese Canadian Women

Background: Chinese Canadian women have higher cervical cancer incidence, and lower Pap testing, rates than the general Canadian population. Predisposing, enabling and reinforcing factors associated with ever having a Pap test, and having a recent Pap test within the last 2 years, were assessed in Chinese women in British Columbia using the PRECEDE-PROCEED model. Method: Chinese women (n=512) between the ages of 20 and 79 years and residing in Greater Vancouver were interviewed about Pap testing, health care, traditional health beliefs, acculturation and sociodemographic characteristics. Two analyses were done, comparing women who had ever and never had a Pap test, and comparing women who had and had not received a recent Pap test. Focus groups and qualitative interviews ensured cultural sensitivity in the survey questionnaire. Results: Seventy-six percent reported ever having a Pap test and 57% reported having a Pap test within the last 2 years. Traditional health beliefs were not associated with ever or recent Pap testing. However, belief that Pap testing prevented cancer and general knowledge about the Pap test were associated with screening. Concern about pain/discomfort with the test, availability of time, culturally sensitive health care services and recommendation for Pap testing by a physician were also associated with screening. Factors differed for ever, and recently, having a Pap test. Interpretation: Pap testing is less common among Chinese Canadian women. Continuing education about Pap testing is recommended for physicians serving underscreened Chinese women. Culturally and linguistically appropriate educational materials are needed for the Chinese community. Contexte : La proportion des Canadiennes d'origine chinoise qui se soumettent au test de Papanicolaou est plus faible, et les taux d'incidence du cancer du col de l'utérus sont plus élevés que dans la population canadienne en général. Nous avons utilisé le modèle PRECEDE/PROCEED pour évaluer la relation entre les facteurs de prédisposition, d'incitation et de renforcement et le fait d'avoir ou de ne pas avoir subi un test de Papanicolaou au cours des deux dernières années, chez les Canadiennes d'origine chinoise de la Colombie-Britannique. Méthode : Nous avons mené des entrevues auprès de femmes d'origine chinoise (n=512) âgées de 20 à 79 ans qui habitent la région métropolitaine de Vancouver. Les questions ont porté sur le test de Papanicolaou, les soins de santé, les croyances tradition