135 Cervical cancer screening among marginalized women of risk factors concerning the development of cervical cancer. Without any possibility to return to their homeland for treatment, they will receive the treatment in the Netherlands, with all the attendant costs included. This is of high importance because the findings suggest that undocumented women also have a high risk on (pre)cancerous cervical abnormalities. The number of participants in the study is too low for definitive conclusions, but more research in this specific subpopulation is firmly recommended. 1. Be pro-active as care provider; 2. Provide the cervical smear at the locations where the women work, reside or receive care; 3. Use a trusted care provider on the location for recruitment and the introduction of the program; 4. Use female medical teams; 5. Involve peers: give them a role in educating and raising awareness; 6. Consider screening from a younger age onward, starting at the age of 25 is recommend; 7. Make sure follow-up is guaranteed and explore regionally which organizations can cooperate. Box 1. Recommendations for implementing a cervical screening program for marginalized women Conclusion The current national population-based cancer screening program for cervical cancer is largely missing out on marginalized women. In view of their increased risk, efforts should be made to enhance screening uptake among marginalized women at the cervical CSP. A tailor-made, direct and pro-active invitation approach will most probably be successful to involve marginalized women in cervical screening. In the discussion suggestions and recommendations are offered for future studies. Both researchers and policymakers are invited to use this study for optimizing the current cervical CSPs. 5
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