Cancer Screening in Refugees and Immigrants: A Global Perspective

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  • 1 HealthPartners Institute, Bloomington, Minnesota;
  • | 2 Department of Medicine, University of Minnesota, Minneapolis, Minnesota;
  • | 3 HealthPartners Center for International Health, Bloomington, Minnesota;
  • | 4 HealthPartners Travel and Tropical Medicine Center, Bloomington, Minnesota

Clinicians in the United States are trained to screen for cancer based on patient age, gender, family history, and environmental risk factors such as smoking. These cancers generally include, breast, cervical, colon, lung, and prostate cancers. We know that refugees and other immigrants to the United States experience dramatic disparities in cancer screening. Additionally, many immigrants experience elevated risks from infection-attributable cancers due to their country or region of origin. U.S.- based clinicians may not routinely consider these unique risk factors. Although this article focuses on refugees, it is also intended to guide clinicians caring for other foreign-born immigrant groups living in the United States (hereafter referred to as “immigrants”). The document contains two sections: 1) special considerations for U.S. Preventive Services Task Force guidelines cancer screening recommendations in immigrants and 2) cancer risks and screening recommendation unique to certain immigrant groups. Disparities in cancer screening and prevalence are often greater for specific immigrant groups than for broader racial or ethnic groups (e.g., Black, Asian, Hispanic) into which they may fit. Disaggregation of data by language or country of origin is useful to identify such disparities and to design intervention opportunities within specific communities that are culturally distinct and/or who have different environmental exposures. Unique cancer risks and disparities in screening support a nuanced approach to cancer screening for immigrant and refugee populations, which is the focus of this narrative review.

Author Notes

Address correspondence to Patricia F. Walker, 8170 33rd Avenue, MS 21112R, Bloomington, MN 55425. E-mail: patricia.f.walker@healthpartners.com

Financial support: This project was funded by the Centers for Disease Control and Prevention Centers for Excellence in Refugee Health.

Authors’ addresses: Patricia F. Walker and Malini B. DeSilva, HealthPartners Institute, Bloomington, MN, Department of Medicine, University of Minnesota, Minneapolis, MN, and HealthPartners Travel and Tropical Medicine Center, Bloomington, MN, E-mails: patricia.f.walker@healthpartners.com and malini.b.desilva@healthpartners.com. Ann Settgast, HealthPartners Institute, Bloomington, MN, Department of Medicine, University of Minnesota, Minneapolis, MN, HealthPartners Center for International Health, and HealthPartners Travel and Tropical Medicine Center, Bloomington, MN, E-mail: ann.m.settgast@healthpartners.com. Mallory.L.Hall@HealthPartners.com

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