Uptake of breast cancer screening measures among immigrant and Swiss women in Switzerland

BACKGROUND: Early detection of breast cancer plays a crucial role in survival, and in most developed countries immigrant women present for treatment at a later stage of the disease. Compared to the indigenous population, immigrant women have a lower uptake of breast cancer prevention services. The situation for immigrant women in Switzerland is compounded by the fact that all women living in Switzerland are at major risk of developing breast cancer during their lifetime. QUESTION UNDER STUDY: Our study aimed to detect disparities in uptake of preventive methods such as mammography, clinical breast examination (CBE) and breast self-examination (BSE) among women from the four major immigrant groups Italy, Spain, former Yugoslavia and Portugal, compared to the native population in Switzerland. Methods: This study is a secondary analysis of data from the 2002 Swiss Health Survey, a nationwide cross-sectional telephone survey. The self-reported questionnaires addressed immigrant and Swiss women of age 20 and over (n = 9,790). Descriptive statistics were used to describe the demographic characteristics of the sample. The dichotomous variables of interest, mammography, CBE and BSE were adjusted for nationality and further sociodemographic factors using logistic regression, with Swiss women serving as the comparison group. RESULTS: Main predictors for mammography uptake were higher income and older age. For the use of CBE, lower age, higher income and nationality were the strongest predictors. Women from former Yugoslavia (OR = 2.6) and Portugal (OR = 2.8) more frequently stated that they did not receive CBE compared to Swiss females (p = .011). BSE is linked to a higher socioprofessional status and to nationality. Women from Italy (OR = 1.62) and former Yugoslavia (OR = 2.6) perform BSE significantly less often than Swiss women (p = .0001). CONCLUSION: Differences exist in the use of mammography, CBE and BSE among the four major foreign nationality groups living in Switzerland compared to Swiss nationals. Immigrant and low-income women might draw benefit from a systematic and culturally adapted breast cancer screening programme to overcome disparities in access to screening.