Mammographic screening in Sami speaking municipalities and a control group. Are early outcome measures influenced by ethnicity?

Knowledge, attitudes, and behaviours towards cancer screening in indigenous populations: a systematic review

Cancer mortality among indigenous peoples is increasing, but these populations commonly under use cancer-screening services. This systematic review explores knowledge, attitudes, and behaviours towards cancer screening among indigenous peoples worldwide. Searches of major bibliographic databases identified primary studies published in English up to March, 2014; of 33 eligible studies, three were cohort studies, 27 cross-sectional, and three case-control. Knowledge of and participation in screening was greater for breast cancer than for other cancers. Indigenous peoples tended to have less knowledge, less favourable attitudes, and a higher propensity to refuse screening than non-indigenous populations. The most common factors affecting knowledge, attitudes, and behaviours towards cancer screening included access to screening, knowledge about cancer and screening, educational attainment, perceived necessity of screening, and age. Greater understanding of knowledge, attitudes, and behaviours towards cancer screening in diverse indigenous cultures is needed so that culturally appropriate cancer prevention programmes can be provided.

Socioeconomic characteristics and health outcomes in Sami speaking municipalities and a control group in northern Norway

Objectives

The Sami people constitute an ethnic minority in northern Norway. The objectives of this study were to compare municipalities with a majority of Sami in the population and a control group with regard to socioeconomic factors and health outcome.

Methods

Original data from Statistics Norway and Directorate of health on socioeconomic factors (education, unemployment, disability, poverty) and health outcomes [total mortality, cancer specific mortality, cardiovascular disease (CVD) specific mortality] were imported from the “Health Atlas” at the Northern Norway Regional Health Authority (NNRHA) trust. The 8 municipalities in the administration area of the Sami language law (Sami-majority group – 18,868 inhabitants) was compared with a control group consisting of 11 municipalities where the Sami constitute a small minority in the population (18,931 inhabitants). Most data were from 2005 and 2008.

Results

There was no significant difference in socioeconomic factors. Overall, cancer- and CVD-specific mortality rates were similar in both groups. The life expectancy was significantly longer among women in the Sami-majority area (81.3 vs. 79.5 years, p=0.035) and males (74.5 vs. 72.0 years, p=0.037).

Conclusion

Socioeconomic factors and cause-specific mortality rate were similar in the Sami-majority group and the control group. Residents of both sexes in Sami-majority areas enjoyed longer life expectancy.

Mammographic screening in Sami speaking municipalities and a control group. Are early outcome measures influenced by ethnicity?

OBJECTIVES

Female citizens of Sami (the indigenous people of Norway) municipalities in northern Norway have a low risk of breast cancer. The objective of this study was to describe the attendance rate and outcome of the Norwegian Breast Cancer Screening Program (NBCSP) in the Sami-speaking municipalities and a control group.

STUDY DESIGN

A retrospective registry-based study.

METHODS

The 8 municipalities included in the administration area of the Sami language law (Sami) were matched with a control group of 11 municipalities (non-Sami). Population data were accessed from Statistics Norway. Data regarding invitations and outcome in the NBCSP during the period 2001-2010 was derived from the Cancer Registry of Norway (CRN). The NBCSP targets women aged 50-69 years. Rates and percentages were compared using chi-square test with a p-value<0.05 as statistical significant.

RESULTS

The attendance rate in the NBCSP was 78% in the Sami and 75% in the non-Sami population (p< 0.01). The recall rates were 2.4 and 3.3% in the Sami and non-Sami population, respectively (p<0.01). The rate of invasive screen detected cancer was not significantly lower in the Sami group (p=0.14). The percentage of all breast cancers detected in the NBCSP among the Sami (67%) was lower compared with the non-Sami population (86%, p=0.06).

CONCLUSION

Despite a lower risk of breast cancer, the Sami attended the NBCSP more frequently than the control group. The recall and cancer detection rate was lower among the Sami compared with the non-Sami group.