Medical tourism and cervical cancer screening among immigrant women

From the Ko Group, Public Health Sciences Division

One of the most common factors associated with cancer screenings among immigrant women is duration of stay in the United States. Recent literature reports that immigrant women who have lived in the US longer have higher cervical cancer screening than those who have lived in the US for a short period of time. Women who have lived in the US for ten years or more have 1.4 higher odds of cervical cancer screening compared to those who have lived in the US for less than 10 years. A high percentage of immigrant women engage in medical tourism which means they visit a foreign country, usually their home country for healthcare services. Immigrants may experience more barriers to accessing healthcare in the US than those native to the US.  Within the recent decades, medical tourism has increased among immigrants.  Currently, the literature lacks research that reports the frequency of medical tourism among difference races/ethnicities or years lives in the US. In this study, the aims to examine whether medical tourism is associated with cervical cancer screening among immigrant women and whether the association between medical tourism and cervical cancer screening varies by years lived in the US. This study was published in BMC’s Women Health.

This study utilized data from the New Immigrant Survey (NIS), a multi-cohort longitudinal data set, that collected data from permanent residents in 2003–2004 and 2007-2009. The main outcome variable included participating in cervical cancer screening after becoming a permanent resident. Logistic regression was utilized to examine the association between medical tourism and cervical cancer screening while controlling for covariates. The largest group in the NIS was Hispanic, followed by non-Hispanic Asian and Pacific Islanders, non-Hispanic whites, and non-Hispanic black. The main predictor variable was medical tourism. Immigrant women who engaged in medical tourism had 2.18 higher odds of receiving a Pap smear compared to immigrant women who did not engage in medical tourism.  Also, there wasn’t a significant difference in medical tourism between non-recent and recent groups.

The Ko Group stated, “recent immigrants may encounter more language and cultural barriers to navigate the U.S. healthcare system and may prefer procedures/screenings (including cervical cancer screenings) in other countries. Moreover, the impact of having health insurance on cervical cancer screening was much lower for recent immigrants than non-recent immigrants (OR = 1.95 vs. 3.44, respectively).”  This novel study is the first to evaluate medical tourism, years spent in the US, and cervical cancer screening among different race/ethnic immigrant groups. The Ko Group elaborated on medical tourism among permanent residents, “whereas medical tourism could be beneficial in the short term, immigrant women may need to be educated on how to navigate the healthcare system in the U.S. and enroll in private or public insurance systems. Linking immigrants to community health centers could also be an option for those who cannot participate in the insurance system or those who are underinsured.”

This research was supported by the National Institutes of Health and by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea.

Fred Hutch/UW Cancer Consortium member Dr. Hendirka Meischke and Dr. Linda K. Ko contributed to this work.

Jang SH, Meischke H, Ko LK. The impact of medical tourism on cervical cancer screening among immigrant women in the US. BMC Women's Health. 2021 Dec;21(1):1-9.