Socioeconomic, Lifestyle and Biological Determinants of Cervical Screening Coverage: Lolland-Falster Health Study, Denmark

Overview

Journal Eur J Public Health

Publisher Oxford University Press

Specialty Public Health

Date 2023 Jun 9

PMID 37295965

Authors

Milad K Tabatabai

Soren Lophaven

Jeannet Lauenborg

Therese Holmager

Randi Jepsen

Elsebeth Lynge

Affiliations

Soon will be listed here.

Abstract

Background: Cervical cancer is preventable. Screening is important for early detection. However, even in high-income countries, coverage is sub-optimal. We identified socioeconomic, lifestyle and biological determinants of cervical screening coverage.

Methods: In Denmark, women aged 23-64 are free of charge personally invited to screening. All cervical cell samples are registered centrally in the Patobank. We linked data from the Lolland-Falster Health Study (LOFUS) with Patobank data. LOFUS was a population-based health survey undertaken in 2016-2020. With logistic regression, coverage defined as ≥1 cervical sample registered within a 6-year period from 2015 to 2020 was compared across levels of risk factors expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results: Among 13 406 women of screening aged 23-64 and invited to LOFUS, 72% had ≥1 cervical sample registered. Non-participation in LOFUS was a strong predictor of low coverage; aOR 0.32; 95% CI 0.31-0.36. Among LOFUS participants, education was a strong predictor of coverage in univariate analysis, OR 0.58; 95% CI 0.48-0.71, but this association disappeared in multi-variate analysis, aOR 0.86; 95% CI 0.66-1.10. In multi-variate analysis, predictors of low coverage were high age, living without a partner, retired, current smoker, poor self-rated health, elevated blood pressure and elevated glycated haemoglobin.

Conclusions: Women with low cervical screening coverage had limited contact to healthcare, exemplified by non-participation in LOFUS, and pertinent health and social problems, exemplified by elevated blood pressure and glycated haemoglobin, poor self-rated health, and retirement already in screening age. Structural changes in screening are needed to reach non-screened women.

Citing Articles

Non-participation in breast screening in Denmark: Sociodemographic determinants.

von Euler-Chelpin M, Napolitano G, Lynge E, Borstrom S, Vejborg I BMC Public Health. 2024; 24(1):2024.

PMID: 39075424 PMC: 11285456. DOI: 10.1186/s12889-024-19547-x.

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