Comparing Cervical Cancer Stage At Diagnosis In Immigrant Women And Long-Term Residents

e18054 Background: Globally, cervical cancer is the fourth most common cancer in women and seventh most common cancer overall. Cervical cancer is highly preventable with HPV vaccination and screening. Previous work has shown that immigrants are less likely to be screened than non-immigrants. Building on this work, the objective of our study was to examine whether immigrant women are more likely to present with later stage cervical cancer than long-term residents. Methods: We conducted a retrospective cohort study of women with cervical cancer diagnosed from 2010 to 2014 using administrative health data from the Canadian province of Ontario, comparing the odds of late stage diagnosis between immigrants and long-term residents. The outcome of interest was stage of cervical cancer diagnosis, defined as early (stage I) or late (stage II-IV). We compared immigrants and long-term residents on late vs. early stage adjusting for socioeconomic measures, comorbidities and healthcare utilization. We also confirmed results with a cohort from 2007-2012. Results: Complete staging data was available for 218 immigrants and 874 non-immigrants. We found no association between immigrant status and stage at diagnosis (adjusted OR: 0.935, p value = 0.739). Factors that did show significant association with later stage diagnosis were physician characteristics, whether a woman had been previously screened, or having visited a gynecologist in the past 3 years. These results were echoed in the 2007-2012 cohort (immigrants vs. long-term residents OR: 0.942, adjusted p value = 0.6773). Conclusions: Our results show that being an immigrant is not associated with late stage diagnosis of cervical cancer, although getting screened or having visited a gynecologist did reduce the odds of later stage cancer. Our findings support previous studies showing that physician characteristics influence immigrant healthcare utilization. Moreso, it may be that programs broadly aimed immigrants require a targeted approach to address higher-risk subgroups.