Kristensson Jenny Hansen, Sander Bente Braad, von Euler-Chelpin My, Lynge Elsebeth
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark.
Cancer Epidemiol. 2014 Apr;38(2):174-80. doi: 10.1016/j.canep.2013.12.007. Epub 2014 Jan 18.
The aims of this study were to identify demographic and socio-economic predictors of non-participation in cervical screening in Denmark, and to evaluate the influence of health care use on screening participation.
A population based register study was undertaken using data from the Central Population Register, the national Patobank, and Statistics Denmark. The study included women aged 25-54 years on 1st of January 2002, living in Denmark during the next 5 years, and without a history of total hysterectomy, N=1,052,447. Independent variables included age, civil status, nationality, level of education, and use of health care. Associations with non-participation in screening were determined with logistic regression.
Main predictors of non-participation were limited or no contact with dental services (odds ratio (OR)=2.36), general practitioners (OR=1.75), and high age (OR=1.98). Other important factors for non-participation were primary school education only (OR=1.53), not being married (OR=1.49), and foreign nationality (OR=1.32).
A 2-1.5-fold difference in non-participation in cervical screening in Denmark was found across various population sub-groups. Increased screening compliance among women with primary school education only, and limited or no use of primary health care services in general could potentially diminish the current social inequalities in cervical cancer incidence, and thus decrease the overall high incidence of this disease in Denmark.
本研究旨在确定丹麦未参与宫颈癌筛查的人口统计学和社会经济预测因素，并评估医疗保健利用情况对筛查参与率的影响。
采用基于人群的登记研究，使用来自中央人口登记册、国家病理数据库和丹麦统计局的数据。研究纳入了2002年1月1日年龄在25 - 54岁之间、在接下来5年居住在丹麦且无全子宫切除史的女性，N = 1,052,447。自变量包括年龄、婚姻状况、国籍、教育程度和医疗保健利用情况。通过逻辑回归确定与未参与筛查的关联。
未参与筛查的主要预测因素是与牙科服务接触有限或无接触（优势比（OR）= 2.36）、与全科医生接触有限或无接触（OR = 1.75）以及高龄（OR = 1.98）。其他未参与筛查的重要因素是仅接受过小学教育（OR = 1.53）、未婚（OR = 1.49）和外国国籍（OR = 1.32）。
丹麦不同人群亚组在未参与宫颈癌筛查方面存在2至1.5倍的差异。仅接受小学教育的女性以及总体上有限或未使用初级卫生保健服务的女性中筛查依从性的提高，可能会减少目前宫颈癌发病率方面的社会不平等现象，从而降低丹麦这种疾病的总体高发病率。
