Implementation of grassroots enlightenment and screening programs are warranted in this population to decrease the screening disparity experienced by this burgeoning population.Based on the findings from this review, African Immigrant (AI) women should be targeted for education about the importance of cervical cancer screening to bridge the knowledge gaps and multilevel initiatives could lead to improved access and utilization of screening services among this growing immigrant population.
This systematic review evaluates the state of cervical cancer screening research in AIs and identifies current gaps.
From this review, we found a low screening adherence rate among AIs.
The awareness and utilization of Pap screening is increasing in Sub-Saharan Africa.
However, the unavailability and inaccessibility of cervical cancer screening services continue to lead to only a small percentage of women being screened in sub-Saharan Africa . may be disproportionately affected by cervical cancer due to health care factors, culturally determined beliefs and attitudes, and cervical cancer screening barriers [26-28].
These recommendations are for women at average risk and do not apply to women at increased risk for cervical cancer such as women who have a history of cervical dysplasia or cervical cancer; women who have been exposed in utero to diethylstilbestrol, or women who are immunocompromised .
Recommended screening practices should not change based on HPV vaccination status .The common factors influencing cervical cancer screening practices among AIs included immigration status, health care interactions, knowledge deficiency, religiosity and certain personal characteristics.A multilevel approach to address the factors influencing screening practices among AIs is essential for improving adherence to screening guidelines.Insufficient awareness of cervical cancer screening recommendations may deter AI women from completing Pap screening  after they migrate to the U. AIs may not have had any Pap screening prior to coming to the U. Consequently, cervical cancer screening appears to be underutilized among AI populations whose screening rates are much lower than the proposed Healthy People 2020 objective of 93% of women age 21 to 65 receiving screening based upon current guidelines . In the only identified systematic review of cancer control research focused on U. AIs, Hurtado-de Mendoz and colleagues (2014)  examined cancer related studies that included African-born immigrants to the U. This review was conducted in May 2013 and was not specific to cervical cancer screening.To date, scant research has examined the current state of cervical cancer screening in AIs or identified research gaps to inform future research and interventions.Women receiving Pap screening based on guideline recommendations and intervals is critical to reducing cervical cancer related morbidity, mortality, and economic burden . S mortality reduction would be 86%-93%, and lifetime cost would be approximately 00-00, and 24 quality-adjusted life-years would be gained [10,18].To improve the health and economic burden of cervical cancer, the Pap screening patterns of ethnic minorities and underserved populations must be understood since these populations are disproportionately affected by cervical cancer. AIs differ by country of origin, reasons for migration, primary languages spoken, health practices and beliefs, human capital, education status, and cultural background .Currently, there exists a limited understanding of the factors influencing cervical cancer screening among African immigrants (AIs) to the U. Sub-Saharan Africa is historically a region of intense migration and population movement prompted by demographic, economic, ecological and political factors . From 1980 to 2013, the African population in the U. Immigrants bring with them their health profiles and health-related knowledge, values, beliefs, and perceptions reflecting their cultural background .Hence, the African immigrant (AI) group is a rapidly growing population in the U. Cervical cancer screening services have been poorly implemented in many developing countries because of the high cost of health services, poor health infrastructures, insufficient numbers of pathologists and technicians, lack of resources, and accessibility particularly by people living in the rural areas since many of the available services are based in secondary and tertiary health care facilities located in urban areas [4,24].Every year 530,000 women worldwide are diagnosed with cervical cancer, and approximately 275,000 die from the disease .Cervical cancer is the second most common cancer among women worldwide [1,2], is the most common cause of cancer in Africa , and is the leading cause of cancer-related deaths among women in developing countries [1,4].