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Open Access

Peer-reviewed

Research Article

A scoping review of the levels, implementation strategies, enablers, and barriers to cervical, breast, and colorectal cancer screening among migrant populations in selected English-speaking high-income countries

  • Resham B. Khatri ,

    Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Software, Validation, Visualization, Writing – original draft, Writing – review & editing

    rkchettri@gmail.com

    Affiliations School of Public Health, The University of Queensland, Brisbane, Australia, Health Social Science and Development Research Institute, Kathmandu, Nepal

    ⨯
  • Aklilu Endalamaw,

    Roles Data curation, Investigation, Methodology, Validation, Writing – review & editing

    Affiliations School of Public Health, The University of Queensland, Brisbane, Australia, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia

    ⨯
  • Darsy Darssan,

    Roles Investigation, Methodology, Validation, Visualization, Writing – review & editing

    Affiliation School of Public Health, The University of Queensland, Brisbane, Australia

    ⨯
  • Yibeltal Assefa

    Roles Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing – review & editing

    Affiliation School of Public Health, The University of Queensland, Brisbane, Australia

    ⨯

Abstract

Background

Cancer remains one of the leading causes of mortality and morbidity worldwide with colorectal, cervical, and breast cancers accounting for significant proportion of preventable deaths. Early screening, diagnosis, and treatment could prevent many of these deaths. However, migrants face persistent disparities in the screening, early diagnosis, and treatment of these cancers. This study synthesizes evidence on cancer screening uptake, implementation strategies, as well as their enablers and barriers among migrants in English-speaking high-income countries (Australia, the USA, the UK, Canada, and New Zealand).

Methods

We conducted a scoping review of studies published in any language between 1 January 2015 and 31 December 2024. Studies were retrieved from four databases: PubMed, Scopus, Embase, and Web of Science. Search terms were developed based on four domains: types of cancer (colorectal, cervical, and breast), migrant populations, screening coverage, and country of residence. The uptake of cancer screening among migrants in selected countries was determined. A thematic analysis was conducted to analyze the data and identify key themes related to the implementation of cancer screening strategies, as well as their enablers and barriers.

Results

A total of 80 studies were included in the review. Migrants exhibited varied levels of utilization of cancer screening such as cervical cancer (41% − 84%), breast cancer (24%−87%), and colorectal cancer (4%−55%). Four themes related to the implementation of cancer screening strategies were identified: i) culturally tailored health education and communication, ii) trust-building initiatives with providers and health systems, iii) family and community support for acculturation and engagement, iv) awareness and knowledge on increased risk perception. Several barriers to the implementation of cancer screening strategies were identified, including lack of insurance, transportation challenges, difficulty in speaking and understanding English, inflexible work hours of health services, cultural taboos, stigma, poverty, and undocumented (illegal) status of migrants. Enablers of the implementation of cancer screening strategies included faith-based messaging on cancer screening, community partnerships, home-based fecal immunochemical test kits, availability of after-hours services, gender-concordant care, social networks, acculturation, and trust-building.

Conclusions

The uptake of cancer screening (breast, cervical, colorectal) varied and had low among migrants (e.g., refugees, culturally and linguistically diverse populations). Targeted, culturally tailored approaches, expanding interpreter services, and fostering cross-sector collaborations (e.g., linking screenings to cultural events) are essential for addressing disparities in cancer screening among migrants. Culturally sensitive and adaptive, equity-focussed interventions on cancer screening should be prioritized by ensuring sustained funding, disaggregated data collection on the uptake of cancers screening and design and implementation of programs on targeting diverse population groups.

Citation: Khatri RB, Endalamaw A, Darssan D, Assefa Y (2025) A scoping review of the levels, implementation strategies, enablers, and barriers to cervical, breast, and colorectal cancer screening among migrant populations in selected English-speaking high-income countries. PLoS One 20(8): e0329854. https://doi.org/10.1371/journal.pone.0329854

Editor: Magdalena Szaflarski, University of Alabama at Birmingham, UNITED STATES OF AMERICA

Received: May 7, 2025; Accepted: July 22, 2025; Published: August 14, 2025

Copyright: © 2025 Khatri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: This study does not contain any raw data. All relevant publicly available secondary data included in this paper are available in the Supporting information files.

Funding: The author(s) received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Cancer remain one of the leading causes of morbidity and mortality globally, and is emerging as a major health problem in low- and middle-income countries (LMICs) [1]. Migration from LMICs to high income countries (HICs), especially the United States of America (USA), the United Kingdom (UK), Australia, Canada, and New Zealand (hereafter collectively called English-speaking countries), is increasing, and migrants currently constitute one of the most important priority population groups [2]. For example, migrants constitute 30% of the population in Australia [3], 14% each in the and the USA [4] and UK [5], 27% in New Zealand [6], and 22% in Canada [7]. Despite the evidence that early screening for those cancers is effective in both prevention and treatment, disparities in screening uptake persist among many priority populations, including migrants [8].

Colorectal cancers (CRC), cervical cancers, and breast cancers are major types of cancers where screening programs are beneficial for early prevention and treatment. For example, in 2020, CRC was the third most common form of cancer worldwide [9], with global prevalence of 18 per 100,000 in 2022, with prevalence in UK (31), USA (27), Canada (29), Australia (35), and New Zealand (39) [10]. In 2022, cervical cancer had a global prevalence of 13 cases per 100,000, with higher rates observed in LMICs [11]. Early diagnosis via screening program such as fecal immunochemical tests (FIT) or colonoscopy for early diagnosis and effective treatment can reduce CRC related mortality by 40–60% [12]. Similarly, the cervical cancer claims 342,000 lives annually worldwide, while countries like the UK (8), USA (6), Canada (7), Australia (5), and New Zealand (5) reported lower rates (per 100,000) of cervical cancer deaths [11,13]. Cervical cancer is also preventable through human papilloma virus (HPV) vaccination and screening (pap test for HPV) [13]. Breast cancer is the most diagnosed cancer globally, exhibited varying prevalence: the UK (94), USA (96), Canada (89), Australia (101), and New Zealand (94) had higher rates than the global average of 46 per 100,000 [14] while mammography screening can reduce mortality by 20–30% [13,15].

Countries like Australia, the USA, the UK, New Zealand, and Canada have established screening programs for cancers. For instance, in Australia, key cancer screening programs include the National Breast Cancer Screening (BCS) Program, the National Cervical Screening Program, and Breast Screen Australia [16]. In the USA, the Colorectal Cancer Control Program and the National Breast and Cervical Cancer Early Detection Program aim to address cancer screening needs [17]. In the UK, the National Health Service (NHS) Bowel Cancer Screening [18], Cervical Cancer Screening Programme [19], and NHS Breast Screening programs are available through the NHS program [18,20]. In New Zealand, the National Screening Unit oversees breast and cervical cancer screening, and bowel cancer screening is being phased in nationwide [21]. In Canada, cancer screening programs are primarily managed at the provincial level, with initiatives such as the Breast Screening Program and varying CRC screening programs across provinces [22].

The uptake of cancer screening varies in these English-speaking countries. For instance, in 2022–2023, more than 1.9 million eligible people (50–74 years) were screened through BreastScreen Australia, representing 52% of the target population. Meanwhile, 73% of eligible participants aged 25–74 engaged in the NCSP, with 42% of the 6.3 million invited individuals taking part in the program [23]. In New Zealand, 69% of eligible women were screened for breast cancer [24], 74% for cervical cancer [25], and 58% for bowel cancer [26]. In 2023, more than three in four (75.8%) of women aged 21–65 were up-to-date with cervical cancer screening (CCS), 79.8% of women aged 50–74 had a mammogram in the past 2 years, and 72.6% of adults aged 50–75 received colorectal cancer screening (CRCS) according to the latest guideline [27]. For the fiscal year 2022/23, screening coverage was 66.6% for breast cancer, 67.0% for cervical cancer in those aged 25–49 and 74.9% for cervical cancer in those aged 50–64, and 72.0% for bowel cancer in those aged 60–74 [28]. In Canada, over one-third of eligible individuals miss timely CRCS and at least one-quarter of eligible women miss their recommended breast and CCS [29].

These English speaking high-income countries have made strides in population-level screening for cancers; however, several barriers still hinder screening service utilization among migrants and preventing many cancer deaths [30]. Improving cancer screening uptake among migrants is critical for achieving health equity among priority population groups, especially populations of migrant backgrounds, in these countries [31,32]. This study synthesizes the level of cancer screening among migrants, implementation strategies, and their enablers and barriers. The findings of this scoping review could strengthen cancer screening for early diagnosis among migrant populations.

Materials and methods

We conducted a scoping review of available literature on cancer screening among migrants in selected English-speaking high-income countries. The review methods and reporting of the findings were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Extension for Scoping Reviews (PRISMA-ScR) checklist (Supplementary File, S1 Table) [33,34]. We adhered to the methodological framework of scoping reviews proposed by Arksey and O’Malley [35], which was further refined by Levac and colleagues [36].This framework includes six steps: (a) identifying research questions, (b) identifying relevant documents, (c) selecting documents, (d) extracting and charting data, (e) summarizing and reporting of findings, and (f) engaging public and expert involvement (optional).

Identifying research question

The following question guided the scoping review: What are the levels of cancer screening coverage among migrants in selected English-speaking countries, implementation strategies for cancer screening, and their enablers and barriers?

Identifying relevant documents

Search terms were organized under five domains: i) cancer types (e.g., bowel/colorectal, cervical, and breast), ii) migrants (e.g., migrants, culturally and linguistically diverse groups, refugees), iii) screening coverage (e.g., uptake, usage, utilization, acceptance), and iv) location (e.g., USA, UK, Canada, Australia, and New Zealand). The last author (YA), in coordination with a librarian, developed a search strategy, which was independently reviewed and verified by other authors. The search strategy was tested in PubMed and search terms were revised after initial searches revealed new terms. Studies were retrieved from four databases: PubMed, Scopus, Embase, and Web of Science. A detailed search strategy tailored for each database is provided in the Supplementary file (S2 Table). Searches were conducted across databases from 1 January 2015–31 December 2024. The first author (RBK) searched the records on 6 January 2025. Selection criteria were based on the following domains: population, interventions, outcomes, study design, geography (country of residence), publication year, and accessibility [S3 Table)]. The review included all types of primary studies irrespective of study design (e.g., qualitative, quantitative, and mixed methods) and language of publication. However, no studies were identified that were published other than English.

Selection of documents

Selected records were imported into Covidence to screen the titles and abstracts for the identification of the list of studies. The first author (RBK) initially screened the titles and abstracts and identified the list of potentially eligible studies for the full-text review. The second author (AE) independently evaluated the eligibility of each title and abstract for the included studies. RBK and AE then independently assessed the full text of relevant studies using an Excel sheet approved by the author team. The author team then cross-checked for any discrepancies, discussed them, and reached an agreement through further review.

Citations, abstracts, and full-text articles were managed and reviewed using EndNote (X20) reference manager. No studies were excluded based on methodological quality.

Extraction and charting of data

A template in a Microsoft Excel (Microsoft Corporation, 2020) sheet (covering first author, year, title, objective, design, study types, population, country, migrants, location, cancer types, sample size, people screened, time of screening, frequency of screening, healthcare provider, cost, facilitators/enablers, and barriers) was developed to extract data from each eligible study [S4 Table)]. After the full-text review, data from selected studies were extracted into the data extraction template.

Summarizing and reporting the findings

Quantitative data were analyzed to identify the level of screening for cancers among migrants. Thematic analysis was conducted for qualitative data to generate themes related to implementation strategies for cancer screening, as well as their enablers and barriers. The thematic analysis involved specific activities such as familiarization with data, construction of themes based on a priori themes, indexing, charting, and interpretation [37]. First, descriptive statistics of included studies (e.g., design, countries, types of cancer, migrant groups) were presented in a figure. Second, the level of cancer screening uptake by type and migrant group in selected countries was presented. Third, themes related to implementation strategies were explained narratively, with their barriers and facilitators summarized in a table. Quantitative and qualitative findings were integrated and discussed in the discussion section.

Patient and public involvement

This scoping review did not involve patients or the public or was unable to consult with experts working in the field to validate and confirm our findings. We have included this as a limitation of study.

Results

Fig 1 presents the study selection process for this review (Fig 1). A total 80 studies were included in the review.

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Fig 1. PRISMA-ScR flowchart showing study selection.

https://doi.org/10.1371/journal.pone.0329854.g001

Descriptive analysis of the total studies included in the review is reported in the Supplementary file (S5 Table). Of total 80 studies, nearly half of them were conducted in the USA (47.5%), with no studies from New Zealand. The highest number of studies focused on migrants from African region (20%), followed by immigrants (country of origin unspecified) (16%), and South Asian migrants (14%). More than half of the studies (52.4%) focused on CCS, followed by breast cancer screening (BCS) (31.3%), and CRCS (16.3%).

Cancer screening among migrants

Table 1 presents utilization rates of CCS, BCS, and CRCS in the USA, the UK, Australia, and Canada. Regarding of the CCS, Screening in the UK was up to 75% [38], in the USA it ranges from 41% to 82.7% [39–41], in Australia it ranges from 43.9% to 76.9% [42,43], while in Canada it ranges from (74–77%) [44,45]. This indicates that screening rates are heterogeneous among different migrant groups such as among Hindu women in the UK (75%) [38], Filipinas: 82.7%; Asian Indians: 66.8%, and Arab: 41%) in the USA [39–41], and Asian women in Australia (43.9%) [42], and migrants in Canada (74%) [44,45] [Table 1]. Additionally, BCS in the USA ranges from 24–35% to 86% [46–49], in Australia it ranges from 31.4% −54.5% [50], and in Canada it ranges from 35.3% and 87% [51,52], indicating that screening rates are heterogeneous among different migrant groups such as in the USA (Chinese: 85.5% [53], Arab women (lifetime):86% [46,47], recent screening:24–35%) [48,49]), Australia (Korean women clinical breast examination: 31.4% and biennial mammogram: 54.5% [50]) and Canada (Asian:87% [51], and Sub-Saharan Africans:35.3%) [52]) [Table 1]. Finally, CRCS in the USA ranges from 23% to 55% [54,55], and in Canada it ranges from 4% to16.6% [56,57], indicating that screening rates are heterogeneous among different migrant groups. For example, the screening rates in the USA are among Asian Indians (55%) [54], Chinese (50.9%) [53], and Vietnamese (23%) [55], and (59%) [58] while in Canada, the fecal occult blood test (FOBT) rate are is among refugees/immigrants (4%) [56] and Eastern Europeans (16.6%) [57].

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Table 1. Percentage of uptake of cervical, breast and colorectal cancer screening among migrants in selected English-Speaking high-income countries.

https://doi.org/10.1371/journal.pone.0329854.t001

Summary of implementation strategies, and their enablers and barriers

Fig 2 summarizes the enablers and barriers to cancer screening in the UK, USA, Canada, and Australia [Fig 2]. Broader strategies for implementation included culturally tailored education and communication, trust-building initiatives with providers and the health system, family and community support for acculturation and engagement, and awareness and knowledge of increased risk perception.

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Fig 2. Summary of enablers, and barriers of cancer screening among migrants in English speaking high-income countries.

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Culturally tailored health education and communication

Culturally tailored health education has improved cancer screening rates and awareness among diverse populations. In the USA, tailored health education approaches were found to improve uptake of mammography among Chinese immigrants [53,70], while CCS improved among Karen-Burmese, Bhutanese, and Somali refugees by addressing cultural and religious barriers [71–73]. In Australia, culturally sensitive programs enhanced engagement among CALD women [65,74–76]. Culturally relevant education interventions were effective in addressing barriers and boosting cancer screening rates for South Asian immigrants [42,47,77] and Muslim women in Canada [52,78,79]. CCS interventions such as HPV self-sampling and peer-led initiatives built trust and overcame changing socio-cultural norms and stigma against cancer screening among Turkish, Arab, and Somali women [40,47,80], refugees [72,81], Spanish-speaking women [73], Korean Americans [48], Iraqi/Syrian refugees [82], Arabic/Italian women [83], and Latina women [64]. Similar successes were seen in the UK and Canada, emphasizing community health workers and tailored strategies for cancer screening to address myths and build trust [84,85]. Culturally tailored education for cancer screening such as peer-led programs and community health workers was found effective raising awareness against stigma on cancer screening among migrants such as Turkish women [40], Arab women [47,80], Afghan refugees [86], countering fatalism and stigma in the USA [87], and overcoming cultural taboos (e.g., taking Pap smears and mammograms by male providers, and concerns of privacy) and reliance on family for health decisions in UK [88]. Such culturally tailored educational interventions influenced and motivated participation in screening for cancer among Pacific Islander women [89], leveraged for decision making among migrants of Latino [90], and Muslim backgrounds [91].

Furthermore, personalized and accessible communication has proven effective in increasing cancer screening rates. For example, it led to higher mammogram booking rates in Australia [83], and was effective in increasing CCS among women from Chamorro/ Samoan/Tongan [89] and South Asian backgrounds [42]. Addressing knowledge gaps, particularly among individuals with lower-level education and limited English proficiency, has been critical [42,65,75,76]. Tailored communication was reported to increase awareness and self-monitoring of disease conditions, thereby helping to reduce language barriers [49,58,83,92]. These strategies were effective in addressing challenges in communication and understanding English among Korean Americans [92]), Iraqi/Syrian refugees [82], Karen-Burmese refugees [71], Serbian/Macedonian communities [93], Bhutanese refugees [61,94], and Haitian women [95]. Culturally tailored communication through peer groups and community members was found to increase health literacy and encourage cancer screening (e.g., mammograms) among Spanish-speaking migrants [73,96], Thai women in Australia [97], and Chinese migrants [98]. The provision of interpretation services has been successful in addressing linguistic and communication barriers, tackling on misinformation, thereby improving health access to enhance CRCS rates for Arab women [68,83], Haitian Americans [95], Arab migrants [57,77], and raising awareness among ethnic minority groups [84,88,93].

Nevertheless, the lack of culturally tailored education contributed to increased equity gaps migrant populations often avoiding screening [46,47], among new/recent immigrants [99], South Asians [63], South Asians in the UK [38], and also among Somali and Latino migrants in the USA [72,100]. The lack of culturally focused screening interventions led to negative attitudes toward checkups, which influenced delays in screening (e.g., mammography) among Bhutanese refugees in Australia [94,101], women from the MENA region in Canada [80] and among Myanmar Americans [102]. Such culturally insensitive information was reported to delay the uptake of screening among immigrant Arab women facing reduced mammography use [77], Polish women in Scotland [103], and South Asian American Muslim women [87], and Black and South Asian women using colonoscopy services [88]. Modesty concerns regarding healthcare, along with reduced cancer screening rates, were noted among Muslim women in Canada and the USA [52,79], promiscuity concerns among Latinas [90], South Asian Muslims and Arabic-speaking refugees [41,87], and among Somali immigrants in the USA [81,100]. Poorly personalized language and communication barriers contribute to low screening coverage among South Asian faith groups in the UK [84], Serbian/Macedonian communities in Australia [93], and immigrants and refugees [56], and Thai migrants [97], perceived obstacles among Arabic-speaking refugees [46]. Inadeqaute culturally health education and awareness program were reported to contribute to low screening rates and gaps in uptake persists among Polish women in Scotland [103], and immigrants and refugees in Canada [44,56]. Delayed or reduced care reported in screening programs [68,104], South Asian migrants [84], Serbian/Macedonian [93], Asians [39], and refugees from Bhutanese backgrounds [94].

Trust building initiatives with providers and health system

Trusted health care providers, networks of care workers, and health systems have played a crucial role in overcoming cultural taboos on cancer screening, thereby increasing access to health services [45,52,53,72,78,79,104–107]. Greater trust in healthcare networks plays a vital role in compliance with cancer screening and HPV testing for CCS among East African immigrants [40,59,65,69,72,75,76,86,106]. Additionally, providers’ cultural competence and communication skills were found to increase trust in the health system and engage Chinese American women [108] and Black women from sub-Saharan Africa in preventive health practices [60]. The provision of insurance and addressing structural inequities in CCS were important for refugees and Black African immigrant women in Canada and Australia [45,94,109]. Improving primary care access was essential for addressing barriers, such as work schedules, for South Asian migrants in the UK and the USA [39,66,110]. Furthermore, trust in care providers was found to be effective in addressing privacy concerns and encouraging the utilization of BCS by CALD women [103,107,111]. Migrants who have trust with the health system were found to seek more care for cancer screening among Asian and African migrants in the USA [61,112]. Trust in care providers and primary care access were associated with higher uptake of cancer screenings and adherence among migrants from Muslim backgrounds in Canada [52,78], among Black African immigrants and older immigrant women in the USA [59], and migrants in Australia [62].

Poor trust with health care providers and the health system has led to reduced participation in cancer screening [52] among immigrant and refugees women in Canada [56,75,99]. East African men in the USA also exhibit low screening rates due to distrust in healthcare systems [106].This distrust is further evident in systemic barriers that hinder access to and engagement with preventive healthcare services among Korean immigrants [113] and refugees of Myanmar backgrounds [102].

Family and community support for acculturation and engagement

Social support, family influence, and acculturation have significantly improved cancer screening. These factors helped normalize screening and boost adherence among British-Pakistani women [105], increasing BCS in the USA [48], and improving screening rates among Somali migrants and Latino immigrants [45,90,112]. Supportive environments for CCS were created for Bhutanese refugee women in Australia [42,74], where acculturation, family encouragement in healthcare, and social capital further enhanced participation in cancer screening [62,76,86,112]. Family and community engagement in screening programs have improved cancer screening participation among diverse populations, including Karen-Burmese and Bhutanese refugees [71], and among migrants in Australia [44]. In the USA, these programs leveraged family support to build trust and encourage screening among Somali refugee women [72] and Latinos [73,90,96]. Peer-worker programs have empowered Somali communities in Canada by increasing knowledge and strengthening awareness [56,63,72,85]. Similar societal and community interventions have improved participation in CCS and BCS among women from British Pakistani backgrounds [105], Myanmar American [102], and Bhutanese refugees backgrounds [62,114]. These programs have enhanced awareness, integrated preventive care, and boosted screening uptake [41,115].

Despite some positive outcomes, poor social support and acculturation contribute to significant equity gaps and reduced adherence to CCS among East African immigrants [59], and inadequate up-to-date of CCS among refugees [62]. Low screening rates were prevalent among migrants [46,47], with Black women reporting distrust in healthcare systems and concerns about costs [60,90,95,96,113]. Lack of family and community engagement have resulted in lower screening rates (such as FOBT and mammography) and higher non-adherence among migrants from African backgrounds in Australia [63,66], Muslims and refugees in Canada [57,69]. Newer immigrants and those from Muslim-majority countries have faced similar barriers that influenced lower uptake of cancer screening [65,78], such as South Asian and Latino migrants in the UK [38,116], and Somali refugee women [72]. Furthermore, the lack of effective family and societal interventions has led to struggles in expressing health needs and limited access to health services, resulting in low screening rates among immigrants from China in the USA [108], from Africa in Australia [107,110], and CALD women in Australia [68].

Awareness and knowledge on increased risk perception

Increasing awareness and knowledge to enhance risk perception has been linked to higher cancer screening uptake [47]. For instance, efforts to raise awareness about cancer risk perception have demonstrated positive attitudes toward health check-ups and led to greater participation in cancer screening among Korean migrants [50] and African Australians [66]. Similarly, improved awareness and health literacy have been found effective in reducing stigma, increasing risk perception, countering misinformation, and enhancing understanding and healthcare access, all of which have contributed to increased cancer screening rates [42,65,70,75,76,114,117], especially among refugees [82,116]. The implementation of Health Belief Model interventions has been instrumental in bridging knowledge gaps, improving risk perception and susceptibility, and boosting confidence [48,67,92].

However, a lack of awareness and knowledge about risk perception has contributed to lower BCS rates and barriers to screening among women who are recent immigrants [99], Muslim and South Asian in the USA [72]. Despite awareness, low participation persists among Asian immigrants due to constraints such as time limitations and information gaps [42,76,110,116,117]. Similarly, immigrants from Somali, Black African, and Bhutanese refugee backgrounds in the USA often delay screening until symptoms appear [94,100,115]. Chinese Americans showed reduced screening adherence [53], while Haitian women in the USA had low compliance with referrals [95], and South Asian faith groups in the UK [84]. Similar barriers hindered cancer screening participation among South Asian faith groups in the UK, with South Asian immigrants facing delays in screening until symptoms appear [42,111,117]. These barriers also affect migrants, such as Bhutanese refugees [94], African immigrants [107], and women from MENA region [80]. Migrants from East Africa and the MENA region in Australia often rely on symptomatic care [82], while Asian migrants from Vietnam and Bhutan show lower screening rates [55,101].

Table 2 details the list of enablers and barriers of cancer screening under each broader theme of implementation strategies [Table 2]. Enablers of the implementation of cancer screening include culturally tailored education, and multilingual communication (e.g., co-designed programs, mHealth tools, faith-based messaging, translated reminders, phone interventions) and trusted provider relationships (e.g., female clinicians, interpreters, flexible appointments), all of which improve participation. Family and community support (e.g., peer networks, acculturation) enhance engagement. Awareness campaigns through social media and community education boost risk perception, while self-sampling options increase accessibility. On the other hand, barriers include cultural stigma (e.g., modesty, fatalism), distrust in healthcare, and language gaps that hinder screening. Systemic issues such as cost, time constraints, and inefficient healthcare systems, along with low health literacy and a lack of targeted outreach for immigrants, further reduce screening uptake. Addressing these challenges requires culturally sensitive, community-led strategies and policy reforms.

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Table 2. Implementation strategies and their enablers and barriers of cancer screening in the USA, UK, Canada, and Australia.

https://doi.org/10.1371/journal.pone.0329854.t002

Discussion

This review identified disparities in the uptake of cancer screening among migrant populations in English-speaking HICs. Stark disparities highlight ethnic, migration status, and geographic variations among migrants in these countries. The current review identified that low CRS rates exist for migrant women in the USA (41%) [39–41], Australia (43.9%) [42,43], and also in Canada (74%) [44,45]. Additionally, for BCS, the USA ranges from 24 to 35% [46–49], Australia ranges from 31.4% to 54.5% [50], and Canada had 35.3% [51,52]. For CRCS, the USA ranges has as low as 23% [54,55], and Canada ranges from 4% to16.6% [56,57] which indicate that screening rates are heterogeneous among different migrant groups. In comparison, there was high coverage of the breast, cervical and CRC screening in the USA, UK, Australia and Canada. For instance, for CCS, Australia had 73% [118], the USA had 73% [119], Canada had 87% [120], and the UK had 74.9% [121]. Similarly, for BCS,there was 50% participation in Australia [122], 80% in the USA [119], 69.9% in the UK [121], and 64% in Canada [120]. For CRCS, the national level coverage was 60% in the USA [119], 40% in Australia [123], 71.8% in the UK [121], 53.7% in Canada [120]. Additionally, migrants, refugees, non-English-speaking individuals, and those recently arrived have low participation rates in breast, cervical, and colorectal cancer screening compared to the general populations. Low screening rates were attributed to factors like lack of awareness, cultural stigma, invasive procedures, and systemic barriers including insurance gaps, language difficulties, and discouraging cultural beliefs. This stark equity gaps of the uptake of screening services among migrants and general populations suggests need for focussed service interventions towards universal access to screening services.

Culturally tailored health education, and multilingual communication interventions can address language and communication barriers for improved cancer screening uptake among migrants by ensuring clarity, accessibility, and cultural relevance by integrating community-specific values, trusted messengers, and accessible formats. Cultural stigma, particularly around CCS due to modesty concerns, is prevalent among Middle Eastern and South Asian women in English speaking countries [41,117]. Culturally tailored interventions, such as faith-based messaging (e.g., mosque-delivered education in Muslim communities) and narrative videos addressing cultural myths, have been shown to increase screening [124]. Cultural relevance has been a key factor, with faith leaders endorsing screenings to normalize participation in conservative communities. For instance, discussions around cancer screening in churches increased uptake among African migrants in Canada [125]. To translate these lessons into action, policymakers must fund community-designed interventions and prioritize universal access to culturally competent care [126]. By centering migrant voices in intervention design and addressing structural inequities while building trust in underserved communities progress can be made [127]. Somali refugee women in Minnesota had improved CCS after participating in mosque-based workshops co-designed with imams, which reframed pap smears as aligned with Islamic principles of health preservation, countering fatalism and modesty concerns [128]. In Australia, Korean migrant women increased biennial mammogram participation by using narrative videos in Korean, which normalized screenings as acts of self-care rather than cultural betrayal [50,129]. For example, bilingual community health workers who shared cultural backgrounds developed trust while explaining procedures in Spanish, dispelling myths that Pap smears threaten modesty or fertility for CCS among Latino migrants [90]. Arabic-speaking refugees in Canada engaged more with health services after receiving translated, faith-sensitive mobile app reminders co-developed with community leaders, which simplified instructions [130]. Effective strategies include co-designing interventions with cultural and community leaders to embed faith-based messaging and address fatalistic beliefs, providing bilingual community health workers to deliver home-based education [124], leveraging familial trust to dispel myths, developing multimedia tools (e.g., culturally tailored videos, apps) for improved knowledge and health care [131,132].

Furthermore, prioritizing linguistically accessible and culturally competent communication can bridge understanding gaps, empower informed decision-making, and build trust in healthcare systems, particularly among non-English-speaking, refugee, and uninsured populations, where migration status and socioeconomic vulnerability intersect [133,134]. Multilingual education, including culturally adapted mobile apps, translated reminders, and telehealth pre-screening consultations, has reduced missed appointments and improved adherence among migrants. Targeting specific subgroups, like newer immigrants and male refugees, is crucial for developing effective interventions [8,135]. Effective interventions should target subgroups like newer immigrants and male refugees, using strategies such as simplified CRCS procedures, interpreter services, visual guides, and native-language workshops [136]. In Australia, using professional medical interpreters rather than family members during colonoscopy referrals for Arabic-speaking migrants enhanced trust and reduced stigma [137]. Other interventions include training healthcare providers to use professional interpreters, including gender-concordant ones for sensitive screenings, and developing multilingual digital tools (e.g., apps, videos) co-designed with migrant communities [138]. Additionally, leveraging trusted platforms to distribute low-literacy, visually guided materials (e.g., pictograms, flipcharts) and partnering with ethnic media outlets (e.g., radio, TV) to broadcast screening information in community languages is crucial for reaching populations with limited formal education [139].

Trust in healthcare providers and systems can overcome barriers to cancer screening among migrants by promoting culturally safe, transparent, and collaborative care. Additionally, innovative approaches, such as distributing home-based FIT kits through community clinics, have been effective in raising CRCS rates in the USA [140]. The influence of healthcare providers, along with care provision by female healthcare workers, has been shown to increase Pap test completion among South Asian migrants in the UK [38]. Similarly, East African migrants were more likely to engage with mammography after healthcare systems collaborated with imams to deliver faith-sensitive messaging, reassuring patients that screenings align with Islamic values of health preservation [141]. In Australia, Arabic-speaking migrants reported higher trust in colonoscopy referrals when clinics used professional interpreters reducing concerns about privacy [83]. These strategies respect cultural norms, reduce discrimination fears, and address systemic distrust through cultural competency training for providers, expanding access to interpreters and bilingual staff, and collaborating with trusted community figures to design faith-sensitive screening campaigns [142]. Other strategies include implementing continuity-of-care models where migrants see the same provider repeatedly to build rapport and developing confidential screening pathways to address privacy concerns [143,141]. Policy advocacy, such as state-funded programs that could offer free transportation and flexible hours, and has been effective in increasing mammography uptake among low-income migrants [144].By prioritizing trust-building through culturally congruent care, health systems can mitigate structural inequities and empower migrants to engage proactively with cancer screening.

Not having insurance among migrants significantly limits their access to cancer screening, especially in the USA, as many are unable to afford preventive care without coverage [145]. Lack of insurance limits migrants’ access to cancer screenings, leading to delayed diagnoses and poor health outcomes, exacerbating health disparities and leaving them at higher risk of undiagnosed cancers. Addressing this requires expanding coverage, offering free screenings through community clinics, and integrating screenings into routine care, especially through primary care models and equity-focused programs that target uninsured migrants [146].

Family and community support for acculturation can address cancer screening barriers by fostering collaborative decision-making. Embedding screening support into social and cultural contexts can transform norms into catalysts for screening. Community-driven engagement, such as partnerships with ethnic organizations and trusted leaders, has been effective—e.g., Pacific Islander women in New Zealand increased CCS rates [147]. Social networks, like family encouragement, have significantly influenced cancer screening, as shown by a refugee cohort in the USA where follow-through with colonoscopy referrals doubled [148]. Acculturation also plays a role, with each additional decade of residency associated with higher mammography uptake, highlighting the impact of adapting to host-country healthcare norms over time [149]. Collaboration through social and family networks is key; cross-sector partnerships, such as Australia’s state-community campaigns linking screening to cultural festivals, have led to higher participation compared to clinic-based outreach alone [150]. Potential family and societal interventions for cancer screening could include intergenerational programs where family members act as health advocates, blending traditional values with support (e.g., youth health ambassadors guiding elderly relatives). Peer navigation networks, where acculturated migrants assist newcomers with clinic systems and address logistical concerns, could also be effective [151,152]. Leveraging cultural activities, such as festivals, for interactive health education—through storytelling and games—can help normalize cancer screenings [153]. Additionally, multilingual social media can effectively share survivor stories and practical guides, tailored to linguistic and cultural preferences [154].

Knowledge and awareness are crucial to enhancing risk perception of cancers and encouraging participation in screening programs among migrants. However, knowledge gaps persist, with newer immigrants demonstrating less understanding of CRCS guidelines compared to long-term residents [155]. Limited interpreter services and fragmented primary care access further exacerbate disparities, particularly in the US and UK, hindering equitable cancer screening participation among migrant populations [87,88]. Increasing awareness and knowledge about cancer screening among migrants in English-speaking countries is a crucial intervention to overcome barriers to screening [156,157]. Migrants often face cultural, language, and informational challenges that discourage them from seeking preventative healthcare, including cancer screenings. Providing culturally sensitive educational campaigns in multiple languages can help migrants understand the importance of regular screenings, while also addressing cancer risks specific to their communities [158]. For example, offering workshops, pamphlets, or online resources in migrants’ native languages can bridge language gaps and provide relevant information [158,159]. Healthcare providers should be trained to understand cultural beliefs and fears that hinder screening participation, fostering trust. Addressing misconceptions or stigma through culturally tailored messaging and collaborating with community leaders can further enhance awareness and encourage screening [160]. Collaborating with community leaders and local organizations to raise awareness and promote screenings can strengthen trust and increase participation among migrant populations.

Implications for policy and practice

Fig 3 summarizes the key suggestions for improving cancer screening among migrant populations in English-speaking HICs, under the following key themes [Fig 3]: Co-design interventions with migrant communities, train healthcare providers in cultural competence and the use of professional interpreters, provide accessible and affordable screening services, invest in multilingual and visual education materials, and leverage social and family networks to promote screening.

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Fig 3. Summary of interventions for cancer screening among migrants in English speaking high-income countries.

https://doi.org/10.1371/journal.pone.0329854.g003

Study limitations

This scoping review consolidated evidence from various studies on cancer screening among migrants in the USA, UK, Canada, and Australia, offering a broad understanding of screening uptake, implementation strategies, and their enablers and barriers. However, it lacked a pre-registered or publicly available protocol. Additional limitations include the absence of expert consultation to enhance the triangulation of findings. The review included both qualitative and quantitative studies, which may have contributed to heterogeneity in the results, limiting the possibility of sensitivity analyses or meta-analysis. Future studies should involve stakeholder engagement to strengthen the validity of the findings.

Conclusion

The uptake of cancer screening (breast, cervical, colorectal) varied and had low among migrants, refugees, and CALD populations in selected English-speacking high-income countries. There were several efforts in the implementation of strategies of cancer screening. Persistent barriers such as cultural stigma, language gaps, and mistrust in healthcare systems underscore the need for community-based, tailored interventions that enhance accessibility and trust. Addressing these challenges requires co-designed programs with community leaders, expanded access to culturally and gender-concordant providers, addressing communication gaps in the understanding of English by ensuring interpretation services, and sustained public health education to boost health literacy and encourage participation in screening services. Culturally sensitive and adaptive, equity focussed interventions on cancer screening should be prioritized by ensuring sustained funding, disaggregated data collection on the uptake of cancer screening and design and implementation of program on targeting diverse migrant groups.

Supporting information

S1 Table. PRISMA checklist.

https://doi.org/10.1371/journal.pone.0329854.s001

(DOCX)

S2 Table. Search strategy (databases, search domains and search terms).

https://doi.org/10.1371/journal.pone.0329854.s002

(DOCX)

S3 Table. Inclusion and exclusion criteria for selection of studies in the review.

https://doi.org/10.1371/journal.pone.0329854.s003

(DOCX)

S4 Table. Data extracts from the included studies.

https://doi.org/10.1371/journal.pone.0329854.s004

(XLSX)

S5 Table. Description of studies, design, population, country, migrant groups, and cancer types.

https://doi.org/10.1371/journal.pone.0329854.s005

(DOCX)

References

  1. 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. pmid:30207593
  2. 2. Akbari AH, MacDonald M. Immigration Policy in Australia, Canada, New Zealand, and the United States: An Overview of Recent Trends. Int Migration Rev. 2014;48(3):801–22.
  3. 3. Khatri RB, Assefa Y. Access to health services among culturally and linguistically diverse populations in the Australian universal health care system: issues and challenges. BMC Public Health. 2022;22(1):880. pmid:35505307
  4. 4. Van Hook J, Morse A, Capps R, Gelatt J. Uncertainty About the Size of the Unauthorized Foreign-Born Population in the United States. Demography. 2021;58(6):2315–36. pmid:34568900
  5. 5. Segal UA. Globalization, migration, and ethnicity. Public Health. 2019;172:135–42. pmid:31229257
  6. 6. Carey RN, El-Zaemey S, Daly A, Fritschi L, Glass DC, Reid A. Are There Ethnic Disparities in Exposure to Workplace Hazards Among New Zealand Migrants to Australia? Asia Pac J Public Health. 2021;33(8):870–9. pmid:33847173
  7. 7. Gushulak BD, Pottie K, Hatcher Roberts J, Torres S, DesMeules M, Canadian Collaboration for Immigrant and Refugee Health. Migration and health in Canada: health in the global village. CMAJ. 2011;183(12):E952-8. pmid:20584934
  8. 8. Walker PF, Settgast AM, DeSilva MB: Cancer screening in refugees and immigrants: a global perspective. The American Journal of Tropical Medicine and Hygiene 2022, 106(6):1593.
  9. 9. Xi Y, Xu P. Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol. 2021;14(10):101174. pmid:34243011
  10. 10. International agency for research on cancer. Age-standardized rate (world) per 100 000, incidence in 2022 colorectal. 2025.
    • 11. International Agency for Research on Cancer. Age-standardized rate (world) per 100 000, incidence, females, in 2022 cervix uteri. 2025.
      • 12. Kooyker AI, Toes-Zoutendijk E, Opstal-van WAW, Buskermolen M, van Vuuren HJ, Kuipers EJ, et al. Colonoscopy-Related Mortality in a Fecal Immunochemical Test–Based Colorectal Cancer Screening Program. Clinical Gastroenterology and Hepatology 2021, 19(7):1418–25.
      • 13. Hugtenburg J, Pinedo H, Blake S, Gomes Bravio I, Ljumanovic R, Beckeringh J. Evidence of the impact of early detection programmes for cancer. Encyclopedia of evidence in pharmaceutical public health and health services research in pharmacy. Springer. 2022:1–16.
        • 14. International agency for research on cancer. Age-standardized rate (world) per 100 000, incidence, females, in 2022b breast. 2025.
          • 15. Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast. 2022;66:15–23. pmid:36084384
          • 16. Lew J-B, Feletto E, Wade S, Caruana M, Kang Y-J, Nickson C, et al. Benefits, harms and cost-effectiveness of cancer screening in Australia: an overview of modelling estimates. Public Health Res Pract. 2019;29(2):29121913. pmid:31384886
          • 17. Wong FL, Miller JW. Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program: Increasing Access to Screening. J Womens Health (Larchmt). 2019;28(4):427–31. pmid:30969905
          • 18. Scott SE, Rauf B, Waller J. “Whilst you are here…” Acceptability of providing advice about screening and early detection of other cancers as part of the breast cancer screening programme. Health Expect. 2021;24(5):1868–78. pmid:34369071
          • 19. Choi S, Ismail A, Pappas-Gogos G, Boussios S. HPV and Cervical Cancer: A Review of Epidemiology and Screening Uptake in the UK. Pathogens. 2023;12(2):298. pmid:36839570
          • 20. Hackshaw A, Cohen SS, Reichert H, Kansal AR, Chung KC, Ofman JJ. Estimating the population health impact of a multi-cancer early detection genomic blood test to complement existing screening in the US and UK. Br J Cancer. 2021;125(10):1432–42. pmid:34426664
          • 21. O’Hallahan J, Church E, Shaw C. Cancer screening in New Zealand. J Cancer Policy. 2020;23:100203.
          • 22. Vahabi M, Lofters AK, Kopp A, Glazier RH. Correlates of non-adherence to breast, cervical, and colorectal cancer screening among screen-eligible women: a population-based cohort study in Ontario, Canada. Cancer Causes Control. 2021;32(2):147–55. pmid:33392906
          • 23. Cancer screening. Available from: https://www.aihw.gov.au/reports/australias-health/cancer-screening-and-treatment.
            • 24. Health New Zealand: BreastScreen Aotearoa Coverage Report. In.; 2025.
              • 25. Health New Zealand: National Cervical Screening Programme Coverage Report. 2025.
                • 26. Health New Zealand. National bowel screening programme. 2025.
                  • 27. National Cancer Institute: Cancer Trends Progress Report. In. National Cancer Institute, NIH, DHHS: Bethesda, MD, 2025.
                    • 28. England N. Cancer services profiles, 2023 annual update. 2025.
                      • 29. Abdel-Rahman O. Patterns and Trends of Cancer Screening in Canada: Results From a Contemporary National Survey. J Natl Compr Canc Netw. 2021;19(1):68–76. pmid:33406489
                      • 30. Scanlon B, Brough M, Wyld D, Durham J. Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping review. Global Health. 2021;17(1):87. pmid:34321015
                      • 31. Ozturk NY, Hossain SZ, Mackey M, Adam S, Brennan P. HPV and cervical cancer awareness and screening practices among migrant women: A narrative review. Healthcare. MDPI. 2024. p. 709.
                        • 32. Santos Salas A, Bassah N, Pujadas Botey A, Robson P, Beranek J, Iyiola I, et al. Interventions to improve access to cancer care in underserved populations in high income countries: a systematic review. Oncol Rev. 2024;18:1427441. pmid:39564594
                        • 33. McGowan J, Straus S, Moher D, Langlois EV, O’Brien KK, Horsley T, et al. Reporting scoping reviews-PRISMA ScR extension. J Clin Epidemiol. 2020;123:177–9. pmid:32229248
                        • 34. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73. pmid:30178033
                        • 35. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Social Research Methodology. 2005;8(1):19–32.
                        • 36. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69. pmid:20854677
                        • 37. Ahmed SK, Mohammed RA, Nashwan AJ, Ibrahim RH, Abdalla AQ, M. Ameen BM, et al. Using thematic analysis in qualitative research. J Medicine, Surgery, and Public Health. 2025;6:100198.
                        • 38. Cadman L, Ashdown-Barr L, Waller J, Szarewski A. Attitudes towards cytology and human papillomavirus self-sample collection for cervical screening among Hindu women in London, UK: a mixed methods study. J Fam Plann Reprod Health Care. 2015;41(1):38–47. pmid:24521934
                        • 39. Shoemaker ML, White MC. Breast and cervical cancer screening among Asian subgroups in the USA: estimates from the National Health Interview Survey, 2008, 2010, and 2013. Cancer Causes Control. 2016;27(6):825–9. pmid:27106576
                        • 40. Uysal Toraman A, Yildirim N. Knowledge About Cervical Cancer Risk Factors and Practices of Pap Testing Among Turkish Immigrant Women in the United States. J Immigr Minor Health. 2018;20(5):1222–9. pmid:28929252
                        • 41. AlAbdulKader AM, AlAsfour A, Golembiewski M, Gullett H. Disparities in cervical cancer screening among Arabic-speaking women refugees. Ethn Health. 2023;28(8):1115–27. pmid:37337316
                        • 42. Alam Z, Ann Dean J, Janda M. Cervical screening uptake: A cross-sectional study of self-reported screening attitudes, behaviours and barriers to participation among South Asian immigrant women living in Australia. Womens Health (Lond). 2022;18:17455057221096240. pmid:35509249
                        • 43. Perks J, Algoso M, Peters K. Nurse practitioner (NP) led care: Cervical screening practices and experiences of women attending a women’s health centre. Collegian. 2018;25(5):493–9.
                        • 44. Yuill S, Egger S, Smith MA, Velentzis L, Saville M, Kliewer EV, et al. Participation in the national cervical screening programme among women from New South Wales, Australia, by place of birth and time since immigration: A data linkage analysis using the 45 and up study. J Med Screen. 2024;31(1):35–45. pmid:37464811
                        • 45. Whalen-Browne M, Talavlikar R, Brown G, McBrien K, Wiedmeyer M-L, Norrie E, et al. Cervical Cancer Screening by Refugee Category in a Refugee Health Primary Care Clinic in Calgary, Canada, 2011-2016. J Immigr Minor Health. 2022;24(6):1534–42. pmid:35233682
                        • 46. Alkhaifi S, Padela AI, Hodge F, Brecht M-L. Breast cancer screening among immigrant Muslim arab women in the United States: Analyzing relationships between beliefs, knowledge, spousal support and mammogram utilization. J Natl Med Assoc. 2023;115(3):302–13. pmid:36967269
                        • 47. Alkhaifi S, Badr H. Association between Breast Cancer Knowledge and Mammogram Utilization among Immigrant Muslim Arab Women in California: Cross-Sectional Design. Healthcare (Basel). 2022;10(12):2526. pmid:36554050
                        • 48. Lee HY, Stange MJ, Ahluwalia JS. Breast cancer screening behaviors among Korean American immigrant women: findings from the Health Belief Model. J Transcult Nurs. 2015;26(5):450–7. pmid:24848345
                        • 49. Jin SW, Lee J, Yun Lee H. Analyzing factors associated with decisional stage of adopting breast cancer screening among Korean American women using precaution adoption process model. Ethn Health. 2021;26(3):431–47. pmid:30326735
                        • 50. Kwok C, Lee M-J, Lee CF. Breast Cancer Perceptions and Screening Behaviours Among Korean Women in Australia. J Immigr Minor Health. 2020;22(1):126–33. pmid:31025150
                        • 51. Hippman C, Moshrefzadeh A, Lohn Z, Hodgson ZG, Dewar K, Lam M, et al. Breast Cancer and Mammography Screening: Knowledge, Beliefs and Predictors for Asian Immigrant Women Attending a Specialized Clinic in British Columbia, Canada. J Immigr Minor Health. 2016;18(6):1441–8. pmid:26706472
                        • 52. Vahabi M, Lofters A, Kim E, Wong JP-H, Ellison L, Graves E, et al. Breast cancer screening utilization among women from Muslim majority countries in Ontario, Canada. Prev Med. 2017;105:176–83. pmid:28916289
                        • 53. Sentell TL, Tsoh JY, Davis T, Davis J, Braun KL. Low health literacy and cancer screening among Chinese Americans in California: a cross-sectional analysis. BMJ Open. 2015;5(1):e006104. pmid:25564140
                        • 54. Nagpal N, McCready TM, Xia YH, Lin K, Glenn M, Ng S, et al. Predictors of Colonoscopy Use Among Asian Indians in New York City, 2003 to 2016. J Clinical Gastroenterology. 2024;58(9):875–81.
                        • 55. Bhimla A, Zhu L, Twardus S, Lin T, Vo S, Do P, et al. Examining multilevel neighborhood socioeconomic characteristics associated with colorectal cancer screening in Vietnamese Americans residing in Philadelphia County. Transl Behav Med. 2022;12(3):489–97. pmid:35298654
                        • 56. Wang AMQ, Yung EM, Nitti N, Shakya Y, Alamgir AKM, Lofters AK. Breast and Colorectal Cancer Screening Barriers Among Immigrants and Refugees: A Mixed-Methods Study at Three Community Health Centres in Toronto, Canada. J Immigr Minor Health. 2019;21(3):473–82. pmid:29968004
                        • 57. Vahabi M, Lofters A, Wong JP-H, Ellison L, Graves E, Damba C, et al. Fecal occult blood test screening uptake among immigrants from Muslim majority countries: A retrospective cohort study in Ontario, Canada. Cancer Med. 2019;8(16):7108–22. pmid:31568705
                        • 58. Kim K, Chandrasekar E, Lam H. Colorectal Cancer Screening among Chinese, Cambodian, and Vietnamese Immigrants in Chicago. J Racial Ethn Health Disparities. 2015;2(4):473–80. pmid:26863553
                        • 59. Tsegaye AT, Lin J, Cole AM, Szpiro A, Rao DW, Walson J, et al. Adherence and correlates of cervical cancer screening among East African immigrant women in Washington State. J Racial Ethn Health Disparities. 2024.
                        • 60. Adebola A, Adaeze A, Adeyimika D, Lovoria WB, Gia M-M. Experiences and Challenges of African American and Sub-Saharan African Immigrant Black Women in Completing Pap Screening: a Mixed Methods Study. J Racial Ethn Health Disparities. 2024;11(3):1405–17. pmid:37129785
                        • 61. Kue J, Hanegan H, Tan A. Perceptions of Cervical Cancer Screening, Screening Behavior, and Post-Migration Living Difficulties Among Bhutanese-Nepali Refugee Women in the United States. J Community Health. 2017;42(6):1079–89. pmid:28455671
                        • 62. Elmore CE, Mitchell EM, Debnam K, Keim-Malpass J, Laughon K, Tanabe KO, et al. Predictors of cervical cancer screening for refugee women attending an international family medicine clinic in the United States. Cancer Causes Control. 2022;33(10):1295–304. pmid:35978212
                        • 63. Vahabi M, Lofters A, Kumar M, Glazier RH. Breast cancer screening disparities among immigrant women by world region of origin: a population-based study in Ontario, Canada. Cancer Med. 2016;5(7):1670–86. pmid:27105926
                        • 64. Mendoza-Grey S, Ramos-Muniz J, Armbrister AN, Abraído-Lanza AF. Mammography Screening Among Latinas: Does Gender and Ethnic Patient-Physician Concordance Matter? J Immigr Minor Health. 2021;23(5):986–92. pmid:33660103
                        • 65. Anaman JA, Correa-Velez I, King J. A survey of cervical screening among refugee and non-refugee African immigrant women in Brisbane, Australia. Health Promot J Austr. 2017;28(3):217–24. pmid:27802410
                        • 66. Ogunsiji OO, Kwok C, Fan LC. Breast cancer screening practices of African migrant women in Australia: a descriptive cross-sectional study. BMC Womens Health. 2017;17(1):32. pmid:28412942
                        • 67. Lam M, Kwok C, Lee M-J. Prevalence and sociodemographic correlates of routine breast cancer screening practices among migrant-Australian women. Aust N Z J Public Health. 2018;42(1):98–103. pmid:29235719
                        • 68. O’Hara J, McPhee C, Dodson S, Cooper A, Wildey C, Hawkins M, et al. Barriers to Breast Cancer Screening among Diverse Cultural Groups in Melbourne, Australia. Int J Environ Res Public Health. 2018;15(8):1677. pmid:30087259
                        • 69. Shen SC, Lofters A, Tinmouth J, Paszat L, Rabeneck L, Glazier RH. Predictors of non-adherence to colorectal cancer screening among immigrants to Ontario, Canada: a population-based study. Prev Med. 2018;111:180–9. pmid:29548788
                        • 70. Wu T-Y, Lin C. Developing and evaluating an individually tailored intervention to increase mammography adherence among Chinese American women. Cancer Nurs. 2015;38(1):40–9. pmid:24621965
                        • 71. Ornelas IJ, Ho K, Jackson JC, Moo-Young J, Le A, Do HH, et al. Results From a Pilot Video Intervention to Increase Cervical Cancer Screening in Refugee Women. Health Educ Behav. 2018;45(4):559–68. pmid:29202606
                        • 72. Allen EM, Lee HY, Pratt R, Vang H, Desai JR, Dube A, et al. Facilitators and Barriers of Cervical Cancer Screening and Human Papilloma Virus Vaccination Among Somali Refugee Women in the United States: A Qualitative Analysis. J Transcult Nurs. 2019;30(1):55–63. pmid:30170512
                        • 73. Ochoa CY, Murphy ST, Frank LB, Baezconde-Garbanati LA. Using a Culturally Tailored Narrative to Increase Cervical Cancer Detection Among Spanish-Speaking Mexican-American Women. J Cancer Educ. 2020;35(4):736–42. pmid:31020621
                        • 74. Power R, Ussher JM, Hawkey A, Missiakos O, Perz J, Ogunsiji O, et al. Co-designed, culturally tailored cervical screening education with migrant and refugee women in Australia: a feasibility study. BMC Womens Health. 2022;22(1):353. pmid:35987620
                        • 75. Williams C, Goulbourne E, Gyansa E, Hashi A, Khalil I, Khan R, et al. Initiatives to increase breast and cervical cancer-related knowledge, screening, and health behaviours among Black women. Can J Public Health. 2024.
                        • 76. Alam Z, Dean JA, Janda M. What do South Asian immigrant women know about HPV, cervical cancer and its early detection: A cross-sectional Australian study. J Migr Health. 2022;5:100102. pmid:35480875
                        • 77. Alatrash M, Alkrisat S. Knowledge, Age, and Perceived Social Barriers Regarding Mammography Screening Among Immigrant Arab Women in the United States: A Predictive and Associative Analysis. J Womens Health (Larchmt). 2024;33(10):1385–92. pmid:38979628
                        • 78. Lofters AK, Vahabi M, Kim E, Ellison L, Graves E, Glazier RH. Cervical Cancer Screening among Women from Muslim-Majority Countries in Ontario, Canada. Cancer Epidemiol Biomarkers Prev. 2017;26(10):1493–9. pmid:28939586
                        • 79. Vahabi M, Lofters A. Muslim immigrant women’s views on cervical cancer screening and HPV self-sampling in Ontario, Canada. BMC Public Health. 2016;16(1):868. pmid:27557928
                        • 80. Eldol D. Perceptions of breast cancer screening programs and breast health among immigrant women: Qualitative study in Alberta. Can Fam Physician. 2024;70(7–8):491–6. pmid:39122428
                        • 81. Pratt R, Mohamed S, Dirie W, Ahmed N, VanKeulen M, Ahmed H, et al. Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study. BMC Public Health. 2017;17(1):270. pmid:28320350
                        • 82. Bartlett R, Robinson T, Anand J, Negussie F, Simons Smith J, Boyle JA. Empathy and journey mapping the healthcare experience: a community-based participatory approach to exploring women’s access to primary health services within Melbourne’s Arabic-speaking refugee communities. Ethn Health. 2022;27(3):584–600. pmid:32116007
                        • 83. Beauchamp A, Mohebbi M, Cooper A, Pridmore V, Livingston P, Scanlon M, et al. The impact of translated reminder letters and phone calls on mammography screening booking rates: Two randomised controlled trials. PLoS One. 2020;15(1):e0226610. pmid:31923178
                        • 84. Palmer CK, Thomas MC, McGregor LM, von Wagner C, Raine R. Understanding low colorectal cancer screening uptake in South Asian faith communities in England--a qualitative study. BMC Public Health. 2015;15:998. pmid:26423750
                        • 85. Ahmad F, Ferrari M, Moravac C, Lofters A, Dunn S. Expanding the meaning of “being a peer leader”: qualitative findings from a Canadian community-based cervical and breast cancer screening programme. Health Soc Care Community. 2017;25(2):630–40. pmid:27109693
                        • 86. Siddiq H, Pavlish C, Alemi Q, Mentes J, Lee E. Beyond Resettlement: Sociocultural Factors Influencing Breast and Colorectal Cancer Screening Among Afghan Refugee Women. J Cancer Educ. 2022;37(2):352–61. pmid:32638290
                        • 87. Kazi E, Sareshwala S, Ansari Z, Sahota D, Katyal T, Tseng W, et al. Promoting Colorectal Cancer Screening in South Asian Muslims Living in the USA. J Cancer Educ. 2021;36(4):865–73. pmid:32279246
                        • 88. Kerrison RS, Gil N, Travis E, Jones R, Whitaker KL, Rees C, et al. Barriers to colonoscopy in UK colorectal cancer screening programmes: Qualitative interviews with ethnic minority groups. Psychooncology. 2023;32(5):779–92. pmid:36929590
                        • 89. Tanjasiri SP, Mouttapa M, Sablan-Santos L, Weiss JW, Chavarria A, Lacsamana JD, et al. Design and Outcomes of a Community Trial to Increase Pap Testing in Pacific Islander Women. Cancer Epidemiol Biomarkers Prev. 2019;28(9):1435–42. pmid:31186260
                        • 90. Madhivanan P, Valderrama D, Krupp K, Ibanez G. Family and cultural influences on cervical cancer screening among immigrant Latinas in Miami-Dade County, USA. Cult Health Sex. 2016;18(6):710–22. pmid:26671002
                        • 91. Alkhaifi S. “I Trust That Only God Can Protect Me, But …”: The Religious Meaning Behind Mammogram Attitudes and Behaviors Among Immigrant Muslim Women. J Immigr Minor Health. 2024;26(3):546–53. pmid:37980314
                        • 92. Lee H, Ghebre R, Le C, Jang YJ, Sharratt M, Yee D. Mobile Phone Multilevel and Multimedia Messaging Intervention for Breast Cancer Screening: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth. 2017;5(11):e154. pmid:29113961
                        • 93. Phillipson L, Pitts L, Hall J, Tubaro T. Factors contributing to low readiness and capacity of culturally diverse participants to use the Australian national bowel screening kit. Public Health Res Pract. 2019;29(1):28231810. pmid:30972408
                        • 94. Parajuli J, Horey D, Avgoulas M-I. Perceived barriers to cervical cancer screening among refugee women after resettlement: A qualitative study. Contemp Nurse. 2020;56(4):363–75. pmid:32794428
                        • 95. Raynault M-F, Féthière C, Côté D. Social inequalities in breast cancer screening: evaluating written communications with immigrant Haitian women in Montreal. Int J Equity Health. 2020;19(1):209. pmid:33228706
                        • 96. Read SH, Valverde I, Montealegre JR, Rutherford TJ, Anderson ML. Qualitative assessment of knowledge and attitudes towards cervical cancer screening among male Latino immigrants in Houston, Texas. BMC Womens Health. 2020;20(1):141. pmid:32631299
                        • 97. Suwankhong D, Liamputtong P. Early Detection of Breast Cancer and Barrier to Screening Programmes amongst Thai Migrant Women in Australia: A Qualitative Study. Asian Pac J Cancer Prev. 2018;19(4):1089–97. pmid:29699369
                        • 98. Lee-Lin F, Nguyen T, Pedhiwala N, Dieckmann N, Menon U. A breast health educational program for Chinese-American women: 3- to 12-month postintervention effect. Am J Health Promot. 2015;29(3):173–81. pmid:24460003
                        • 99. Vahabi M, Lofters A, Kumar M, Glazier RH. Breast cancer screening disparities among urban immigrants: a population-based study in Ontario, Canada. BMC Public Health. 2015;15:679. pmid:26194189
                        • 100. Ghebre RG, Sewali B, Osman S, Adawe A, Nguyen HT, Okuyemi KS, et al. Cervical cancer: barriers to screening in the Somali community in Minnesota. J Immigr Minor Health. 2015;17(3):722–8. pmid:25073605
                        • 101. Parajuli J, Horey D, Avgoulas MI. Access to breast cancer screening — perception, and perceived barriers among older Bhutanese refugee women resettled in Australia: A qualitative study. Aust J Cancer Nurs. 2019;20(1):14–8.
                        • 102. San-Rozano MM. Breast Health Perceptions and Screening Behaviors Among Myanmar American Immigrant Women. Oncol Nurs Forum. 2024;51(5):483–96. pmid:39162791
                        • 103. Gorman DR, Porteous LA. Influences on Polish migrants’ breast screening uptake in Lothian, Scotland. Public Health. 2018;158:86–92. pmid:29395275
                        • 104. Zhang Y, Ornelas IJ, Do HH, Magarati M, Jackson JC, Taylor VM. Provider Perspectives on Promoting Cervical Cancer Screening Among Refugee Women. J Community Health. 2017;42(3):583–90. pmid:27838808
                        • 105. Khattak HM, Woof VG, French DP, Donnelly LS, Ruane H, Ulph F, et al. The role of knowledge, primary care and community engagement to improve breast-screening access for Pakistani women in the United Kingdom: A secondary analysis of a qualitative study. J Health Serv Res Policy. 2023;28(3):149–56. pmid:37039238
                        • 106. Nakajima M, Mohamud S, Haji A, Pratt R, al’Absi M. Barriers and facilitators of colorectal cancer screening among East African men in Minnesota: a qualitative investigation. Ethn Health. 2024;29(1):112–25. pmid:37968812
                        • 107. Anaman-Torgbor JA, King J, Correa-Velez I. Barriers and facilitators of cervical cancer screening practices among African immigrant women living in Brisbane, Australia. Eur J Oncol Nurs. 2017;31:22–9. pmid:29173823
                        • 108. Seo JY, Li J, Li K. Cervical Cancer Screening Experiences Among Chinese American Immigrant Women in the United States. J Obstet Gynecol Neonatal Nurs. 2018;47(1):52–63. pmid:29144960
                        • 109. Ojerinde AC, Thorne SE, Howard AF, Kazanjian A. Cervical cancer screening uptake and experiences of Black African immigrant women in Canada. Glob Qual Nurs Res. 2024;11:23333936241266997.
                        • 110. Nelson M, Patton A, Robb K, Weller D, Sheikh A, Ragupathy K, et al. Experiences of cervical screening participation and non-participation in women from minority ethnic populations in Scotland. Health Expect. 2021;24(4):1459–72. pmid:34137135
                        • 111. Chandrakumar A, Hoon E, Benson J, Stocks N. Barriers and facilitators to cervical cancer screening for women from culturally and linguistically diverse backgrounds; a qualitative study of GPs. BMJ Open. 2022;12(11):e062823. pmid:36375978
                        • 112. Sewali B, Okuyemi KS, Askhir A, Belinson J, Vogel RI, Joseph A, et al. Cervical cancer screening with clinic-based Pap test versus home HPV test among Somali immigrant women in Minnesota: a pilot randomized controlled trial. Cancer Med. 2015;4(4):620–31. pmid:25653188
                        • 113. Cha EY, Chun H. Barriers and Challenges to Cervical Cancer Screening, Follow-Up, and Prevention Measures among Korean Immigrant Women in Hawaii. Asia Pac J Oncol Nurs. 2021;8(2):132–8. pmid:33688561
                        • 114. Parajuli J, Horey D, Avgoulas M-I. Best practice models recommended by Bhutanese refugee women for cervical and breast cancer screening in Australia: A qualitative study. Health Promot J Austr. 2020;31(3):381–90. pmid:31833117
                        • 115. Cofie LE, Whitt O, Bhagat N. Personal networks and cervical cancer screening among Black immigrant women. J Racial Ethn Health Disparities. 2024.
                        • 116. Marlow L, McBride E, Varnes L, Waller J. Barriers to cervical screening among older women from hard-to-reach groups: a qualitative study in England. BMC Womens Health. 2019;19(1):38. pmid:30808349
                        • 117. Alam Z, Deol H, Dean JA, Janda M. Reasons behind Low Cervical Screening Uptake among South Asian Immigrant Women: A Qualitative Exploration. Int J Environ Res Public Health. 2022;19(3):1527. pmid:35162550
                        • 118. Australian Institute of Health and Welfare. National cervical screening program monitoring report 2024. Canberra: AIHW, Australian Government. 2024.
                          • 119. American Cancer Society. Cancer Prevention & Early Detection Facts & Figures 2025-2026. American Cancer Society. 2025. Available from: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-prevention-early-detection-facts-figures-2025-2026.html
                            • 120. Adefemi K, Knight JC, Zhu Y, Wang PP. Concurrent cancer screening participation and associated factors among Canadian women: Insights from a cross-sectional study. J Med Screen. 2025;9691413251333223. pmid:40259573
                            • 121. NHS England: Cancer Services Profiles, 2024 Annual Update. NHS England. 2025. https://www.england.nhs.uk
                              • 122. Australian Institute of Health and Welfare. BreastScreen Australia monitoring report 2024. Canberra: AIHW, Australian Government. 2024.
                                • 123. National bowel cancer screening program monitoring report 2024. Canberra: AIHW, Australian Government. 2024.
                                  • 124. Joo JY, Liu MF. Culturally tailored interventions for ethnic minorities: A scoping review. Nurs Open. 2021;8(5):2078–90. pmid:34388862
                                  • 125. Ojerinde AC, Thorne SE, Howard AF, Kazanjian A. Cervical Cancer Screening Uptake and Experiences of Black African Immigrant Women in Canada. Glob Qual Nurs Res. 2024;11:23333936241266997. pmid:39071450
                                  • 126. Kale S, Hirani S, Vardhan S, Mishra A, Ghode DB, Prasad R, et al. Addressing Cancer Disparities Through Community Engagement: Lessons and Best Practices. Cureus. 2023;15(8):e43445. pmid:37711952
                                  • 127. Scanlon B, Brough M, Wyld D, Durham J. Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping review. Global Health. 2021;17(1):87. pmid:34321015
                                  • 128. Ali MA, Ahmad F, Morrow M. Somali’s perceptions, beliefs and barriers toward breast, cervical and colorectal cancer screening: a socioecological scoping review. IJMHSC. 2021;17(2):224–38.
                                  • 129. Schwebel FJ, Larimer ME. Using text message reminders in health care services: A narrative literature review. Internet Interv. 2018;13:82–104. pmid:30206523
                                  • 130. Nisa S, Murad S, Salma J, Au A. Service-policy gaps in the settlement journey of Arabic-speaking immigrant newcomer and refugee older adults in Edmonton, Canada. PLoS One. 2024;19(10):e0311646.
                                  • 131. Truong M, Paradies Y, Priest N. Interventions to improve cultural competency in healthcare: a systematic review of reviews. BMC Health Serv Res. 2014;14:99. pmid:24589335
                                  • 132. Bertakis KD, Azari R. Patient-centered care: the influence of patient and resident physician gender and gender concordance in primary care. J Womens Health (Larchmt). 2012;21(3):326–33. pmid:22150099
                                  • 133. Lee J, Ewing B, Holmes D. Barriers and Facilitators to Colorectal Cancer Screening in South Asian Immigrants: A Systematic Review. Asian Pac J Cancer Prev. 2023;24(5):1463–75. pmid:37247265
                                  • 134. Huhmann K. Barriers and Facilitators to Breast and Cervical Cancer Screening in Somali Immigrant Women: An Integrative Review. Oncol Nurs Forum. 2020;47(2):177–86. pmid:32078613
                                  • 135. Scanlon B, Brough M, Wyld D, Durham J. Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping. 2021.
                                    • 136. De La Torre CL, Dumbauld JN, Haughton J, Gupta S, Nodora J, Giacinto RE, et al. Development of a Group-Based Community Health Worker Intervention to Increase Colorectal Cancer Screening Among Latinos. Hisp Health Care Int. 2021;19(1):47–54. pmid:32466687
                                    • 137. Alananzeh I, Ramjan L, Kwok C, Levesque JV, Everett B. Arab-migrant Cancer Survivors’ Experiences of Using Health-care Interpreters: A Qualitative Study. Asia Pac J Oncol Nurs. 2018;5(4):399–407. pmid:30271823
                                    • 138. Chan BMC, Suurmond J, van Weert JCM, Schouten BC. Uncovering communication strategies used in language-discordant consultations with people who are migrants: Qualitative interviews with healthcare providers. Health Expect. 2024;27(1):e13949. pmid:39102688
                                    • 139. Mbanda N, Dada S, Bastable K, Ingalill G-B, Ralf W S. A scoping review of the use of visual aids in health education materials for persons with low-literacy levels. Patient Educ Couns. 2021;104(5):998–1017. pmid:33339657
                                    • 140. Martinez SL. Implementing mailed fecal immunochemical test outreach to impact colorectal cancer screening. Grand Canyon University. 2023.
                                      • 141. Rauch JI, Daniels J, Robillard A, Joseph RP. Breast Cancer Screening among African Immigrants in the United States: An Integrative Review of Barriers, Facilitators, and Interventions. Int J Environ Res Public Health. 2024;21(8):1004. pmid:39200613
                                      • 142. Handtke O, Schilgen B, Mösko M. Culturally competent healthcare - A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PLoS One. 2019;14(7):e0219971. pmid:31361783
                                      • 143. McLachlan E, Anderson S, Hawkes D, Saville M, Arabena K. Completing the cervical screening pathway: Factors that facilitate the increase of self-collection uptake among under-screened and never-screened women, an Australian pilot study. Curr Oncol. 2018;25(1):e17–26. pmid:29507491
                                      • 144. Habib SZ. South Asian immigrant women’s access to and experiences with breast and cervical cancer screening services in Canada. University of British Columbia. 2012.
                                        • 145. Adunlin G, Cyrus JW, Asare M, Sabik LM. Barriers and Facilitators to Breast and Cervical Cancer Screening Among Immigrants in the United States. J Immigr Minor Health. 2019;21(3):606–58. pmid:30117005
                                        • 146. Lofters AK, Mark A, Taljaard M, Green ME, Glazier RH, Dahrouge S. Cancer screening inequities in a time of primary care reform: a population-based longitudinal study in Ontario, Canada. BMC Fam Pract. 2018;19(1):147. pmid:30157772
                                        • 147. Brewer N, Foliaki S, Gray M, Potter JD, Douwes J. Pasifika women’s knowledge and perceptions of cervical-cancer screening and the implementation of self-testing in Aotearoa New Zealand: A qualitative study. Lancet Reg Health West Pac. 2022;28:100551. pmid:35991536
                                        • 148. Fang CY, Ragin CC. Addressing Disparities in Cancer Screening among U.S. Immigrants: Progress and Opportunities. Cancer Prev Res (Phila). 2020;13(3):253–60. pmid:32132119
                                        • 149. Adegboyega A, Wu J-R, Mudd-Martin G. Acculturation Strategies and Pap Screening Uptake among Sub-Saharan African Immigrants (SAIs). Int J Environ Res Public Health. 2021;18(24):13204. pmid:34948811
                                        • 150. Subramanian S, Ekwueme DU, Heffernan N, Blackburn N, Tzeng J, DeGroff A, et al. Role of Community-Clinical Partnerships to Promote Cancer Screening: Lessons Learned From the National Breast and Cervical Cancer Early Detection Program. Health Promotion Practice. 2024.
                                        • 151. Ashida S, Hadley DW, Goergen AF, Skapinsky KF, Devlin HC, Koehly LM. The importance of older family members in providing social resources and promoting cancer screening in families with a hereditary cancer syndrome. Gerontologist. 2011;51(6):833–42. pmid:21562055
                                        • 152. Peters R, Ee N, Ward SA, Kenning G, Radford K, Goldwater M, et al. Intergenerational Programmes bringing together community dwelling non-familial older adults and children: A Systematic Review. Arch Gerontol Geriatr. 2021;94:104356. pmid:33567363
                                        • 153. Butsch Kovacic M, Gertz SE. Leveraging Stories to Promote Health and Prevent Cancer. Cancer Prev Res (Phila). 2022;15(7):419–22. pmid:35788832
                                        • 154. Sungur H, Yılmaz NG, Chan BMC, van den Muijsenbergh METC, van Weert JCM, Schouten BC. Development and Evaluation of a Digital Intervention for Fulfilling the Needs of Older Migrant Patients With Cancer: User-Centered Design Approach. J Med Internet Res. 2020;22(10):e21238. pmid:33104008
                                        • 155. Decker KM, Singh H. Reducing inequities in colorectal cancer screening in North America. J Carcinog. 2014;13:12. pmid:25506266
                                        • 156. Ridgeway JL, Njeru JW, Breitkopf CR, Mohamed AA, Quirindongo-Cedeño O, Sia IG, et al. Closing the Gap: Participatory Formative Evaluation to Reduce Cancer Screening Disparities among Patients with Limited English Proficiency. J Cancer Educ. 2021;36(4):795–803. pmid:32052262
                                        • 157. Crawford J, Ahmad F, Beaton D, Bierman AS. Cancer screening behaviours among South Asian immigrants in the UK, US and Canada: a scoping study. Health Soc Care Community. 2016;24(2):123–53. pmid:25721339
                                        • 158. Abraham O, Agoke A, Sanuth K, Fapohunda A, Ogunsanya M, Piper M, et al. Need for Culturally Competent and Responsive Cancer Education for African Immigrant Families and Youth Living in the United States. JMIR Cancer. 2024;10:e53956. pmid:38447129
                                        • 159. Kamaraju S, Merrill J, Wu J, Jeames S, Conroy M, Min H, et al. Patient navigation based care-delivery to reduce inequities in cancer care among immigrants and refugees: a commentary on the successes and the unmet needs. Int J Cancer Care and Delivery. 2022;2(1).
                                        • 160. Anderson de Cuevas RM, Saini P, Roberts D, Beaver K, Chandrashekar M, Jain A, et al. A systematic review of barriers and enablers to South Asian women’s attendance for asymptomatic screening of breast and cervical cancers in emigrant countries. BMJ Open. 2018;8(7):e020892. pmid:29982210