Interventions to increase breast cancer screening attendance among immigrants: a cross-sectional international survey

Immigrant populations demonstrate lower attendance in organized breast cancer screening programs than non-immigrants. Evidence on interventions to increase attendance, and their effectiveness, remains limited. We aimed to map interventions implemented in nationally or regionally organized screening programs to enhance immigrants' attendance and to assess the extent of their systematic evaluation.

We conducted a survey using an electronic questionnaire distributed through the International Cancer Screening Network mailing list and snowball sampling to identify interventions improving breast cancer screening attendance among immigrant populations. Twenty-seven screening programs participated. As the number of eligible programs reached was unknown, response rate could not be calculated. Findings should be considered descriptive rather than representative of international practice. Data were analyzed using descriptive statistics.

Most programs (70%, 19/27) lacked routine systems to monitor immigrants' attendance. Across 10 predefined categories, 111 interventions were reported. Of these, 23% (25/111) had been evaluated, and 9% (10/111) were reported by respondents to have increased attendance. The most frequently implemented interventions were translated materials (70%, 19/27), public advertisements (52%, 14/27), and collaboration with voluntary organizations (52%, 14/27). Evaluation rates varied: 16% (3/19) for translated materials, 21% (3/14) for public advertisements, and 50% (7/14) for voluntary sector partnerships.

Considerable variation exists in data availability on immigrants' attendance. Few interventions have been rigorously evaluated. Strengthening monitoring systems and generating evidence are essential to promote equitable screening attendance, although current findings are partly based on self-reported data and should be interpreted with caution.