Mammograms and cervical tests among Ukrainian refugees and main population: survey in Estonia, 2024
Abstract
Issue: Mammograms and cervical tests aim to reduce cancer-related morbidity and mortality; however, socio-demographic inequalities in uptake persist. This study analysed use of mammography and HPV/PAP testing among 20-64-year-old Ukrainian refugees and main population In Estonia and factors influencing uptake in both groups.
Methods: Data from two cross-sectional surveys in 2024 covering Ukrainian refugees (n = 1060) and general population (n = 1117) of Estonia were used. Outcomes included: mammography within the past two years and never; HPV/Pap test within the past five years and never. Independent variables included age, marital status, education, household financial situation, place of residence, self-rated health, smoking status, body mass index, and health insurance coverage. Associations were estimated using negative log-binomial regression, results presented as prevalence rate ratios (PRR) with 95% confidence intervals (CI).
Results: Refugees were slightly younger (mean age 39.4 vs. 44.5 years), more often urban residents, reported more financial difficulties, and were less likely to have health insurance (13.9% vs. 3.3% uninsured; p < 0.001). There were more women who reported to have never had a mammogram (PPR 1.13; 95% CI:1.02-1.25), cervical Pap-smear or HPV test (PPR 1.93; 95% CI: 1.71-2.19%) among Ukrainian refugees than among the main population. Cervical tests in past five years and mammogram use in past two years was lower among refugees. The proportion of women who reported no cervical tests was higher among both Estonian and Ukrainian single women, women with secondary or vocational education, with poor self-rated health, and without health nsurance. Among refugees, ex-smokers were more likely to report no mammograms.
Lessons: Cancer screening should be provided to refugees free of charge. No big differences in the analysed background factors related to screening attendance between the main population and the refugees were found.
Key messages: • High use of free of charge preventive services emphasizes the need to provide cancer screening to refugees.
• Socio-economic background factors related to screening attendance did not significantly differ between the main population in Estonia and the Ukrainian war refugees.
Related
- Beyond coverage: reviewing barriers and facilitators to healthcare access among Ukrainian refugees
- Evaluating the effect of the MindSpring intervention on empowerment among Ukrainian refugees
- Health needs of Ukrainian war refugees in Europe and beyond: a scoping review
- A gendered acculturation risk: Tobacco and nicotine use among Ukrainian refugees in Switzerland
- Cancer incidence in first-generation migrants and host populations in seven European registries, including Ukrainian-born migrants in Poland: a population-based study
BibTeX
@article{veerus2026mammograms,
title = {{Mammograms and cervical tests among Ukrainian refugees and main population: survey in Estonia, 2024}},
author = {P Veerus and R Hallik and R Reile},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1342},
url = {https://doi.org/10.1093/eurpub/ckag169.1342},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Mammograms and cervical tests among Ukrainian refugees and main population: survey in Estonia, 2024
AU - P Veerus
AU - R Hallik
AU - R Reile
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1342
UR - https://doi.org/10.1093/eurpub/ckag169.1342
AB - Issue: Mammograms and cervical tests aim to reduce cancer-related morbidity and mortality; however, socio-demographic inequalities in uptake persist. This study analysed use of mammography and HPV/PAP testing among 20-64-year-old Ukrainian refugees and main population In Estonia and factors influencing uptake in both groups. Methods: Data from two cross-sectional surveys in 2024 covering Ukrainian refugees (n = 1060) and general population (n = 1117) of Estonia were used. Outcomes included: mammography within the past two years and never; HPV/Pap test within the past five years and never. Independent variables included age, marital status, education, household financial situation, place of residence, self-rated health, smoking status, body mass index, and health insurance coverage. Associations were estimated using negative log-binomial regression, results presented as prevalence rate ratios (PRR) with 95% confidence intervals (CI). Results: Refugees were slightly younger (mean age 39.4 vs. 44.5 years), more often urban residents, reported more financial difficulties, and were less likely to have health insurance (13.9% vs. 3.3% uninsured; p < 0.001). There were more women who reported to have never had a mammogram (PPR 1.13; 95% CI:1.02-1.25), cervical Pap-smear or HPV test (PPR 1.93; 95% CI: 1.71-2.19%) among Ukrainian refugees than among the main population. Cervical tests in past five years and mammogram use in past two years was lower among refugees. The proportion of women who reported no cervical tests was higher among both Estonian and Ukrainian single women, women with secondary or vocational education, with poor self-rated health, and without health nsurance. Among refugees, ex-smokers were more likely to report no mammograms. Lessons: Cancer screening should be provided to refugees free of charge. No big differences in the analysed background factors related to screening attendance between the main population and the refugees were found. Key messages: • High use of free of charge preventive services emphasizes the need to provide cancer screening to refugees. • Socio-economic background factors related to screening attendance did not significantly differ between the main population in Estonia and the Ukrainian war refugees.
SN - 1101-1262
SN - 1464-360X
ER -