Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Cancer Epidemiol Biomarkers Prev. 2018 Nov;27(11):1342-1351. doi: 10.1158/1055-9965.EPI-18-0480. Epub 2018 Aug 14.
Offering human papillomavirus-based self-sampling to nonparticipants in routine cervical cancer screening can increase screening participation. However, little is known about characteristics of women who accept self-sampling. In this population-based study, we investigated determinants for participation in self-sampling among Danish nonattenders to routine cervical cancer screening. During 2014 to 2015, a random sample of screening nonparticipants ages 27 to 65 years living in the Capital Region of Denmark were invited for self-sampling. Of 21,314 eligible women, 4,743 participated in self-sampling. Information on sociodemographic characteristics and mental and physical health of all the women was obtained from nationwide registries, and 3,707 women completed a questionnaire on lifestyle, sexual behavior, and reasons for nonparticipation in routine screening. We used logistic regression to estimate ORs for participation in self-sampling, crude, and adjusted for sociodemographic characteristics. Basic education [OR = 0.79; 95% confidence interval (CI), 0.72-0.88], low income (OR = 0.66; 95% CI, 0.59-0.73), origin from a nonwestern country (OR = 0.43; 95% CI, 0.38-0.48), and being unmarried (OR = 0.66; 95% CI, 0.61-0.72) were associated with lower self-sampling participation. Long-term unscreened women (OR = 0.49; 95% CI, 0.45-0.53), women with prior schizophrenia or other psychoses (OR = 0.62; 95% CI, 0.48-0.80), women with poor self-perceived health (OR = 0.42; 95% CI, 0.25-0.69), and women who perceived screening as unnecessary (OR = 0.54; 95% CI, 0.37-0.80) or irrelevant (OR = 0.81; 95% CI, 0.78-0.96) were less likely to self-sample. Certain population groups, including women with low socioeconomic position or of nonwestern origin, were less likely to participate in self-sampling. Targeted approaches may be needed to increase screening participation in these groups.
为未参与常规宫颈癌筛查的人群提供人乳头瘤病毒自我采样服务，可以增加筛查参与率。然而，对于接受自我采样的女性的特征，我们知之甚少。在这项基于人群的研究中，我们调查了丹麦常规宫颈癌筛查未参与者参与自我采样的决定因素。在 2014 年至 2015 年期间，邀请了居住在丹麦首都地区的 27 至 65 岁、符合条件的筛查未参与者进行自我采样。在 21314 名符合条件的女性中，有 4743 名参与了自我采样。所有女性的社会人口统计学特征以及精神和身体健康信息均从全国登记处获得，其中 3707 名女性完成了一份关于生活方式、性行为以及未参与常规筛查原因的问卷。我们使用逻辑回归估计了自我采样的 OR 值，包括未调整和调整社会人口统计学特征后的 OR 值。基础教育[OR = 0.79；95%置信区间（CI），0.72-0.88]、低收入（OR = 0.66；95%CI，0.59-0.73）、非西方国家出身（OR = 0.43；95%CI，0.38-0.48）和未婚（OR = 0.66；95%CI，0.61-0.72）与较低的自我采样参与率相关。长期未筛查的女性（OR = 0.49；95%CI，0.45-0.53）、有精神分裂症或其他精神病既往史的女性（OR = 0.62；95%CI，0.48-0.80）、自我感知健康状况不佳的女性（OR = 0.42；95%CI，0.25-0.69）以及认为筛查不必要（OR = 0.54；95%CI，0.37-0.80）或不相关（OR = 0.81；95%CI，0.78-0.96）的女性不太可能进行自我采样。包括社会经济地位较低或非西方国家出身的女性在内的某些人群，参与自我采样的可能性较低。可能需要采取有针对性的方法来增加这些群体的筛查参与率。
