Muslim Immigrants in Ontario Cultural Barriers & Cervical Cancer Screening

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Problem Statement

Cervical cancer (CC) is a top-burden international health issue with an approximated incidence of 528,000 and mortality of 266,000 globally in 2012 (Johnson, Armstrong, Joyce, Teitelman, & Buttenheim, 2018). According to Ferdous et al. (2018), it is the third most frequent yet preventable carcinoma among Canadian women. Developed countries like Canada have achieved a significant decrease in the burden of the disease following Pap smear programs (Ferdous et al., 2018). Appropriate screening in Canada has significantly reduced the number of new cases and deaths from CC in recent decades (Lofters, Vahabi, Fardad, & Raza, 2017). While screening is vital for females from adolescent age, the likelihood of Muslim immigrant women to undergo testing in Ontario is minimal (Lofters et al. 2017), thereby causing them higher rates of the disease.

A survey done by the “National Household Survey” in 2011 reported that over 600, 000 out of 1,000, 000 cases of CC in Ontario were Muslim women (Lofters et al., 2017). According to Lofters et al., 60 percent of the 600,000 women are foreign-born (2017). Another investigation by the “Institute for Clinical Evaluate Sciences” (ICES) between 2012 and 2015 found that 47 percent of the 761, 019 Muslim women in Ontario were overdue in their Pap test. Bacal et al. (2019) presume that immigration status links to a notable higher chance of underscreening, irrespective of time in Canada. According to Padela, Peek, Johnson-Agbakwu, Hosseinian, and Curlin (2014), immigration status, racial and ethnic affiliation influence the patterns of pap testing.

Internationally, Muslims represent a notable portion of the community and remains the fastest-growing religion (Attum, Waheed, & Shamoon, 2019). The Muslim faith circumscribes a number of ethnicities and various outlooks relating to healthcare and illness (Attum et al., 2019). While this may influence their health practices, decision-making, and health-seeking behavior, it also poses a challenge to non-Muslim healthcare givers (Attum et al., 2019). According to Lofters et al. (2017), the reason why many immigrant Muslim women refuse to take cancer screening tests is related to religious outlooks. Therefore, providing a high standard of care to persons of the Muslim faith demands a comprehension of the variations in spiritual and cultural values.

The essential variations related to culture that could influence CC screening include touch restriction and modesty (Attum et al., 2019). In a study carried out by Lofters et al. (date?)to explore the acceptability of CC screening among Muslim immigrants, close to 50 percent of the participants showed that screening is an intrusion on privacy. Attum et al. presume that health caregivers of opposite gender interacting with Muslim women should adhere to certain directions whenever possible, including avoiding physical and eye contact (2019). According to Attum et al. (2019), male physicians may need to communicate through the husband when attending to a Muslim woman. With the number of male physicians outnumbering that of female physicians, these cultural issues can impede CC screening and exam involves the intrusion of privacy.

Recognizing the reciprocated interaction between culture and religion is imperative because culture determines religion, and religion influences culture (Beyers, 2017). According to Attum et al. (2019), Muslims view health as a state of social, spiritual, psychological, and physical well-being and considers it as the greatest blessing from God to humankind. Ailing Muslims receive disease with patience, meditation, and prayers and those who are not active in faith may seek religious intercession when facing significant problems (Attum et al., 2019). Ailing persons believe disease, pain, suffering, and demise is a test from God and discerns disease as a trial by which an individual’s sins are cleansed (Attum et al., 2019). Negative religious coping, for instance, observing health issues as a punishment from God linked to lower odds of getting a Pap test among Muslim women (Padela et al., 2014). These beliefs regarding health and illness, therefore, may influence healthcare decisions negatively, thereby affecting the uptake of CC screening practices.