Participation in cervical cancer screening among migrants and non-migrants in primary healthcare in Lisbon: a register-based study

Introduction Cervical cancer screening is a critical preventive measure to reduce the burden of cervical cancer. Yet, disparities persist worldwide, particularly among migrant populations. This study examined cervical cancer screening participation among migrant and non-migrant women enrolled in the primary healthcare centres in the Lisbon district. Methods This cross-sectional study analysed healthcare records from 88278women aged 25–60 years. Participation was assessed based on documented screening within nationally recommended timeframes. Migrants were classified by nationality into Portuguese-speaking and non-Portuguese-speaking groups. Screening participation was compared between groups, adjusting for age, family doctor assignment, primary healthcare unit type and provider gender. Logistic regression identified factors influencing participation. Results Migrants showed lower uptake of cervical cancer screening: 19.6% for non-Portuguese-speaking and 31.9% for Portuguese-speaking migrants, compared with 43.7% in non-migrants. After adjusting for confounders, non-Portuguese-speaking migrants had significantly lower odds of participation (OR 0.46, 95%CI 0.43 to 0.50, p<0.01), while Portuguese-speaking migrants had participation rates similar to non-migrants (p=0.29). Key healthcare factors that were associated with higher participation include enrolment in Family Health Units (FHUs) (OR=3.55, 95% CI 3.41 to 3.70, p<0.01) and having an assigned female family doctor (OR 1.43, 95% CI 1.37 to 1.50, p<0.01). Conclusions Migrant women face unique barriers to cervical cancer screening, particularly language and cultural differences. These findings highlight the need for tailored screening programmes incorporating multilingual support, cultural mediation and self-sampling for human papillomavirus testing as an alternative screening method. Enhancing healthcare delivery through training, improved access to family doctors and more incentive-driven FHUs could significantly improve screening uptake. Addressing these disparities is crucial for advancing health equity and enhancing cervical cancer prevention.