Effect of an Intervention in General Practice to Increase the Participation of Immigrants in Cervical Cancer Screening: A Cluster Randomized Clinical Trial

Despite the influx of migration from low and middle-income countries to high-income countries , research in the field of migrants’ health is lacking, especially in areas such as cancer. Cervical cancer, in particular, is the fourth most common cancer in women, with certain immigrant groups having a higher prevalence. However, immigrant women have lower participation in cervical cancer screening (CCS) programs. This study explored whether an intervention in general practice impacts immigrant women’s participation in the Norwegian CCS program. The study was conducted with 10,360 women across 20 sub-districts in Norway. The intervention consisted of 3 elements: (1) an education session informing GPs of the importance of CCS among immigrants and the best way to encourage their participation, (2) a mouse pad reminder and (3) a poster in the waiting room. In the intervention group, the proportion of immigrant women screened increased by 2.6% in comparison to a 0.6% increase in the usual care control group. Subgroup analyses found that the intervention particularly increased participation in women who were not previously screened at baseline. These results demonstrate that interventions targeting general practice, albeit small, significantly increased CCS participation among immigrant women. In future, engaging with other health care professionals, such as midwives, could further increase immigrant women’s CCS participation.

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