Background: Cervical cancer is preventable cancer through pap test screening. Despite the benefits of cervical cancer screening, immigrant women have markedly lower use of Pap smear testing. Hence, this study aims to determine the barriers to cervical cancer screening among Yemeni female immigrants in Malaysia and the factors related to these barriers.
Methods: A cross-sectional survey was carried out among immigrant Yemeni women staying in Selangor and Kuala Lumpur, Malaysia. Data were collected using a validated modified Arabic version of the Cervical Cancer Awareness Measure (Cervical CAM). Descriptive and inferential analyses were utilized. Adjusted binary logistic regression was performed to find out the factors that increase the probability of facing barriers to the Pap test.
Results: A total of 370 questionnaires were collected. Cognitive barriers were the highest recognized type of barrier to undertaking the Pap test among study participants (74.9%) followed by emotional barriers (13%). Unemployed women were significantly less likely than employed to report an emotional barrier to the Pap test (OR = 0.17, 95% CI: 0.03-0.95). Higher educated women (OR = 3.11, CI: 1.02-9.48) and those still studying (OR = 3.11, CI: 1.02-9.48) were significantly more likely to report practical barriers. Regarding the cognitive barriers, women with tertiary education were significantly less likely than those with primary education to have cognitive barriers (OR = 0.41, CI: 0.19-0.90).
Conclusion: access to health services among immigrant women, including screening for cervical cancer, is a complex issue involving a wide range of barriers. Cognitive barriers associated with sexual activity and the absence of symptoms are the main reason for the decision to not undergo cervical cancer screening. To address this, we recommend adopting a comprehensive approach that integrates education, community engagement, accessibility, and cultural sensitivity to promote the uptake of cervical cancer screening within the Yemeni immigrant community.
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