Who are the under- and never- screened for cancer in Ontario: a qualitative investigation

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• 作者：Dionne Gesink (224)
  Alanna Mihic (224)
  Joan Antal (225)
  Brooke Filsinger (225)
  C Sarai Racey (224)
  Daniel Felipe Perez (226)
  Todd Norwood (225)
  Farah Ahmad (226)
  Nancy Kreiger (224) (225)
  Paul Ritvo (225) (226)
  
  224. Dalla Lana School of Public Health ; University of Toronto ; 155 College St ; Toronto ; ON ; M5T 3M7 ; Canada
  225. Cancer Care Ontario ; Toronto ; ON ; Canada
  226. York University ; Toronto ; ON ; Canada
  
• 关键词：Cancer screening ; Qualitative methods ; Sexual abuse ; Mennonites ; Ethics
• 刊名：BMC Public Health
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：314 KB
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• 刊物主题：Public Health; Medicine/Public Health, general; Epidemiology; Environmental Health; Biostatistics; Vaccine;
• 出版者：BioMed Central
• ISSN：1471-2458

文摘

Background Observed breast, cervical and colon cancer screening rates are below provincial targets for the province of Ontario, Canada. The populations who are under- or never-screened for these cancers have not been described at the Ontario provincial level. Our objective was to use qualitative methods of inquiry to explore who are the never- or under-screened populations of Ontario. Methods Qualitative data were collected from two rounds of focus group discussions conducted in four communities selected using maps of screening rates by dissemination area. The communities selected were archetypical of the Ontario context: urban, suburban, small city and rural. The first phase of focus groups was with health service providers. The second phase of focus groups was with community members from the under- and never- screened population. Guided by a grounded theory methodology, data were collected and analyzed simultaneously to enable the core and related concepts about the under- and never-screened to emerge. Results The core concept that emerged from the data is that the under- and never-screened populations of Ontario are characterized by diversity. Group level characteristics of the under- and never- screened included: 1) the uninsured (e.g., Old Order Mennonites and illegal immigrants); 2) sexual abuse survivors; 3) people in crisis; 4) immigrants; 5) men; and 6) individuals accessing traditional, alternative and complementary medicine for health and wellness. Under- and never-screened could have one or multiple group characteristics. Conclusion The under- and never-screened in Ontario comprise a diversity of groups. Heterogeneity within and intersectionality among under- and never-screened groups adds complexity to cancer screening participation and program planning.