Cancer screening uptake among refugees in high and middle-income countries: a systematic review

Cancer screening is a crucial strategy for reducing cancer morbidity and mortality. Refugees encounter disproportionate challenges in preventive healthcare, yet their cancer screening uptake remain poorly characterized. We aimed to synthesize breast, cervical, and colorectal cancer screening uptake among refugees in high and middle-income countries.

A systematic search was conducted using OVID (Medline, Embase), CINAHL, Web of Science, and Scopus from inception to July 2024 to identify studies reporting breast, cervical, and colorectal cancer screening uptake among refugees. Articles were screened in Covidence, and methodological quality was assessed using the Joanna Briggs Institute checklist. Data were synthesized with a descriptive and narrative approach.

Of 2044 articles retrieved, 23 studies included in the review. Refugees exhibited lower cervical, breast, and colorectal cancer screening uptake than non-refugees with variation across cancer types. Reported rates of ever having Pap test and mammogram among refugee women ranged from 13.9 % to 59 %, and 5.3 % to 63 %, respectively. Commonly cited determinants of cancer screening uptake included education, length of stay, cultural/religious beliefs, and family/provider recommendations.

Refugees had lower cancer screening uptake than host populations. Targeted, culturally informed multilevel interventions addressing their unique barriers are needed to improve refugees access to cancer screening.