Barriers to Breast, Cervical, and Colorectal Cancer Screenings Faced by Refugees Resettled in the United States: A Rapid Review.

Abstract

Millions of refugees fleeing countries with political unrest and war have been resettled in the United States (U.S.). Although refugees resettled in the U.S. are granted access to health insurance, there are large disparities in the use of preventive health services like cancer screenings between refugees and the native-born population. The U.S. Preventative Services Task Force (USPSTF) recommends screening for breast, cervical, and colorectal cancers, which are highly preventable if detected early. Previous research has investigated barriers to screening for breast, cervical, and colorectal cancers that may underlie screening disparities. However, current reviews assessing these barriers do not distinguish between immigrant and refugee populations and primarily cover breast and cervical cancer screenings. This rapid review aimed to identify barriers to breast, cervical, and colorectal cancer screenings experienced by refugee-specific communities resettled in the U.S. Of the 945 articles retrieved from the database searches, 12 articles were selected for analysis. Data extracted from the selected studies included screening barriers, screening rates, and sample demographics. Six key barrier themes were identified: (1) language and health system navigation, (2) cost, transportation, and time, (3) health knowledge and exposure, (4) fear of cancer screening and diagnosis, (5) cultural and religious beliefs, and (6) refugee experience or status. We noted variations in the screening barriers experienced by different refugee ethnic groups and noted the impact of refugee experiences and trauma in shaping refugee perspectives on screening. The findings of this review suggest the need for interventions aimed at increasing screening rates to consider the nuances in perceived barriers by different refugee ethnic groups and the role of trauma associated with refugee experiences in shaping these barriers.