Access and utilisation of cervical cancer screening services among four African immigrant communities in Finland: A qualitative study MERH, 17-19 May 2018, Edinburgh Esther Idehen MSc1 Denise Gastaldo PhD2, Anna-Maija Pietilä PhD3, Mari Kangasniemi PhD3   1 Institute of Public Health & Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Finland 2 Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada 3 Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Finland Research sponsored by Matti and Vappu Maukonen and Saastamoinen Foundations (Esther Idehen)

Background: Cervical cancer Global picture Background: Cervical cancer Globally, cervical cancer is a commonly diagnosed cancer in women (GLOBOCAN 2012). A considerable decrease in incidence rates of the disease has been observed in most developed countries (WHO, 2017). Most cases and about 90% of deaths from cervical cancer were reported in low- and middle-income countries in 2012 (GLOBOCAN 2012). It represents a significant public health challenge. Estimated Cervical Cancer Incidence & Mortality Worldwide Globocan 2012 4.12.2018 MERH, 2018/ Esther Idehen

Access and utilisation of cervical cancer screening services Worldwide, the migrant population raised to 244 million in 2015, about half (52.4%) are women, also in Finland (UN 2015, Statistics Finland, 2017). Studies reported disparities and low cervical cancer screening participation among some immigrant groups (Idehen E. al. 2017, 2018). Understanding how different immigrant groups access and utilise the services is imperative. Need to identify groups at risk for the disease. 4.12.2018 MERH 2018/, Esther Idehen

Cervical screening The good news ….. Cervical cancer is a preventable disease (WHO 2014). HOW? Through regular screening by Pap test. Mostly through organised screening programmes Early detection, effective follow-up, and treatment. Cervical screening and follow-up are recommended for all eligible women (WHO 2013). 4.12.2018 MERH 2018/Esther Idehen

Cervical screening Finland offers free cervical screening age group30-60, depending on the municipality and using a five-year interval (Finnish Cancer registry, 2018). The municipality of residence is responsible for sending personal invitation letters to women identified from the national population register (Anttila et al. 2000) Cost-effective service (Council of the EU 2004). MERH 2018/Esther Idehen EUCAN 2012(IARC) –(1/6/2014

Access and utilisation of cervical cancer screening services Study  aims   To explore immigrant women’s perceptions and experiences in accessing and utilising screening services. Factors that might enable or inhibit access and utilisation of the screening services Methods Participants: Immigrant women of Nigerian, Ghanaian, Cameroonian and Kenyan origin in Finland Age: 27-40 years Data collection: n:30 (9 focus groups discussions) Data analysis: Tape-recorded focus group discussions, transcribed and analysed for identification of central themes. MERH 2018/ Esther Idehen 4.12.2018

Preliminary results: Cervical cancer screening access and utilisation Facilitating factors to screening access and utilisation Screening is free Screening is for early cancer detection Screening accessed through reproductive healthcare clinics. Barriers to screening Lack of screening awareness Limited language skills Misunderstanding of screening MERH 2018/ Esther Idehen 4.12.2018

Conclusion- Main messages These preliminary results demonstrate that; Adequate screening information and culturally-designed programmes are needed: Writing screening invitation letters and information in English, Creating screening awareness and information via many channels (organisations centers and social media). Women not using reproductive healthcare services might need more information. Together, we can win the war of cervical cancer! MERH, 2018 /Esther Idehen 4.12.2018

Thank you! uef.fi Esther Idehen estheri@uef.fi