Cancer screening uptake among migrant background populations: an umbrella review

Abstract Background Cancer is one of the leading causes of death worldwide, with colorectal, breast, cervical, and prostate cancers being among the most common types. Uptake of prevention and early detection strategies varies between native and migrant background populations. While research on disparities in cancer screening uptake among migrant groups exist, many studies do not account for the heterogeneity of these populations, including differences between first- and second-generation migrants. This umbrella review evaluates evidence on cancer screening uptake across these four cancers and identifies barriers and facilitators influencing participation. Methods Reviews on cancer screening uptake and related factors in migrant populations were searched in PubMed and Google Scholar. All types of reviews were included. Evidence was synthesised by distinguishing two groups: first-generation migrants (those who experienced migration) and second-generation descendants (those born in the host country to migrant parents). Results Twenty reviews were included, representing 439 primary studies. Most primary studies lacked clear definitions of migrant populations and relied on non-random sampling methods. When migration background was considered, first-generation migrants had lower cancer screening uptake (e.g., 0-50% for colorectal cancer) than second-generation migrants (23-50%). Screening rates were generally higher in native populations (e.g., 38-86% for cervical cancer) compared to migrant populations (11-69%). Barriers included lower socioeconomic conditions, language, cultural beliefs, limited cancer knowledge and the complexity of the healthcare system. Conclusions Cancer screening rates are lower among migrant populations compared to natives, but second-generation descendants have higher uptake compared to their migrant parents. However, most reviews were based on studies with non-representative samples and limited distinction between migrant subgroups. Key messages • Second-generation descendant of migrants have higher cancer screening uptake than first-generation migrants. • To capture meaningful disparities, research should reflect the diversity of migrant background population - by origin, generation and ethnicity.