Gaps in cancer screening and diagnosis exist for immigrant women across Canada, study suggests

By Ana Gajic

Immigrant women in Ontario and British Columbia were less likely to have their breast cancer captured through screening and their diagnoses took longer than for Canadian-born women, suggests a new study by researchers at the Centre for Urban Health Solutions (C-UHS).

Published this month in BMC Cancer, Dr. Aisha Lofters, a family physician and researcher at C-UHS, and her team found that immigrant women overall were 12 per cent less likely to have a screen-detected breast cancer in both provinces. Significantly, women from East Asia and the Pacific were 15 per cent less likely to have a cancer detected through screening. Researchers analyzed data from ICES and Population Data BC.

“In both provinces, immigrant women’s breast cancer was more often captured because the women had symptoms than Canadian-born women, not necessarily because of screening,” said Dr. Lofters, who is also a researcher at the ICES. “We also found that in Ontario, women from South Asia and from Latin America and the Caribbean were diagnosed at a later stage than Canadian-born women.”

This research was conducted as part of the Canadian Team to Improve Community-Based Cancer Care along the Continuum (CanIMPACT), a multi-province research initiative aimed at improving integration and co-ordination of care along the cancer care continuum.

Through her previous work, Dr. Lofters uncovered that cervical cancer screening disparities exist for immigrant women. Through this study, she set out to understand if there were similar disparities for stage of diagnosis, or the length of the diagnostic interval.

“I hope this work encourages patients to be vigilant about any worrisome breast symptoms, to attend regular breast cancer screening, and to advocate for themselves with their health providers,” Dr. Lofters said.

“I hope it also helps health providers ensure they offer and encourage screening for all patients regardless of background, to be attentive to patient concerns, and to be aware that some patients may be at higher risk of breast cancer than others based on their ancestry.”

Dr. Lofters said she and her team will continue to analyze whether these differences in cancer screening and diagnosis between immigrant women and Canadian-born women impact breast cancer survival. They will also use these findings to work toward high quality primary care for all patients.

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Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.