Physicians who attended medical schools in certain parts of the world, specifically the Caribbean, Latin America, the Middle East, North Africa, South Asia and Western Europe were less likely to screen their patients for cervical, breast and colorectal cancer than Canadian graduates, according to new research.
Researchers at the Institute for Clinical Evaluative Sciences (ICES) and St. Michael’s Hospital found South Asian-trained physicians were significantly less likely to screen South Asian women for cervical cancer than other foreign-trained physicians.
“Our findings may reflect differences in what’s emphasized in medical school curriculums around the world,” said lead author Dr. Aisha Lofters, a family physician at St. Michael’s Hospital and scientist at ICES. “These findings also suggest that there’s a particular gap with South Asian-trained doctors being less likely to perform Pap tests on South Asian women.”
The study, published today in Cancer Medicine, showed that in Ontario’s metropolitan areas, seeing a physician who is male, who does not participate in any type of primary care patient enrolment model, and who has been in independent practice for a shorter period of time tends to be associated with a decreased likelihood of screening patients for cancer, including immigrant patients.
The population-based study looked at 6,303 physicians serving 1,156,627 women eligible for breast cancer screening, 2,730,380 women eligible for cervical screening, and 2,260,569 patients eligible for colorectal screening. The study found that fewer than 40 per cent of physicians were female, and 26.1 per cent were foreign-trained.
“Research has demonstrated that immigrants to Canada are under-screened for breast, cervical and colorectal cancer. Our study also confirms that low income patients are vulnerable to under-screening,” said Lofters.
The researchers add that physicians, particularly primary care physicians, play a very important role in preventive care in general, and can serve as both facilitators and impeders to cancer screening. The researchers stress that physician characteristics should be considered when designing physician-targeted interventions.
ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.
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St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
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