ImmigrantScreen
Project
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This project aims to measure the effect of information and invitations to breast and colorectal cancer screening in the assumed mother tongue, and investigate reasons for why immigrants participate or not in the screening programs for breast and colorectal cancer.
Background and purpose
In Norway, all women between the ages of 50 and 69 are invited every other year to BreastScreen Norway, which is a population-based screening program for breast cancer in Norway. A national screening program for colorectal cancer - ColorectalScreen Norway - was rolled out in 2022/2023. Here, all women and men are invited to participate the year they turn 55.
Breast and colorectal cancer screening aims to detect cancer or precursors to cancer before the disease has spread to other organs. This allows for less aggressive treatment, better treatment success, and a reduction in mortality from the disease. Studies from Norway and other countries have shown that immigrants are less likely to participate in cancer screening than non-immigrants. The reasons are likely to be complex and may be related to socio-economic factors, communication challenges, and various pre- and post-migratory factors.
The Cancer Registry of Norway has therefore initiated the ImmigrantScreen project. The purpose is to investigate whether informing and inviting immigrants to breast and colorectal cancer screening in their assumed mother tongue, in addition to Norwegian, will affect participation. The project will also examine factors that may influence immigrants' decisions to participate in cancer screening programs. A doctoral thesis on immigrants and BreastScreen Norway has already been completed.
Sub-studies and status
Study 1: A randomized controlled trial to investigate whether receiving invitations in one's own mother tongue, in addition to Norwegian, affect participation in BreastScreen Norway among immigrant women. The analysis compare participation among those who received letters in both their assumed mother tongue and Norwegian with participation among those who only received letters in Norwegian.
Status: The sub-study is completed and results published. Se publication list at the bottom of this page.
Study 2: A qualitative study to assess factors that may affect participation in colorectal screening among immigrants born in Poland and Pakistan.
Status: The sub-study is completed and results published. Se publication list at the bottom of this page.
Study 3: A randomized controlled study to investigate whether oral information about colorectal screening in one's assumed mother tongue will increase participation in the ColorectalScreen Norway.
Status: Recruitment is ongoing.
Data
Study 1: The study used information from the Cancer Registry's databases, in accordance with the Cancer Registry Regulations. Information about country of birth and about invitations and attendance in BreastScreen Norway was used. The study population consisted of women aged 50-69 who were invited to participate in BreastScreen Norway and were registered as being born in Algeria, Egypt, the Philippines, Iraq, Lebanon, Morocco, Pakistan, Palestine, Poland, Somalia, Sudan, Syria, or Tunisia.
The project only used data from women who have not objected to the storage of information from their screening examinations in the Cancer Registry. It will be impossible to identify individuals in published results.
Study 2: Thematic analysis were performed based on qualitative interviews with immigrants aged 50 to 60 born in Poland and Pakistan. Interviews were semi-structured and conducted in Polish, Urdu, or Norwegian.
Study 3: The study uses information from the Cancer Registry's databases, in accordance with the Cancer Registry Regulations. Information about country of birth and about invitations and attendance in ColorectalScreen Norway is used. The study population consistes of men and women aged 55 who are invited to participate in ColorectalScreen Norway and are registered as being born in Pakistan or Somalia.
Organization
The Cancer Registry of Norway, NIPH, is data controller for the project and the responsible research institution. We are responsible for obtaining the necessary approvals, collecting data, analyzing the data, and publishing results.
About the project
Project leader: Paula Berstad
PI for Study 1: Solveig Hofvind
PI for Study 2: Sameer Bhargava
Project group: Nadia Iqbal, Phd-student and Gunhild Mangerud, project assistant
Financing: Financing has been secured by the Norwegian Cancer Society
Project duration: 01.08.2020 – 31.08.2025
Data protection: Study 1 and 3 were approved by the Norwegian Directorate of Health for exemption from the duty of confidentiality, giving the Cancer Registry of Norway the possibility to invite participants to screening in both their presumed mother tongue and Norwegian, without asking them for permission in advance. In study 2, informed consent was obtained from the participants.
ClinicalTrails.gov
- Study 1: Increasing access to Breast Cancer Screening Among Immigrants
- Study 3: ImmigrantScreen Telephone Reminder Trial in Colorectal Cancer Screening
Collaborators:
- Esperanza Diaz, førsteamanuensis ved Universitetet i Bergen
- Elżbieta Czapka, Post-doc ved Oslo Met
- Fahim Naeem, representant fra Pakistansk Kulturforening Skedsmo
- Maria Kristiansen, Lektor ved Københavns Universitet, Institut for Folkesundhedsvidenskab
- Marit Solbjør, førsteamanuensis ved NTNU
- Katie Robb, professor/dosent ved Universitetet i Glasgow
- Lesley M. McGregor, førstelektor ved Universitet i Stirling
- Rabia Musavi, daglig leder i LIN (Likestilling, Inkludering og Nettverk)
- Øyvind Holme, overlege ved Sørlandet sykehus Kristiansand og førsteamanuensis ved Universitetet i Oslo