Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark.
Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Gynecology, Copenhagen University Hospital Rigshospitalet, Juliane Maries Vej 10, 2100 Copenhagen, Denmark.
Prev Med. 2019 Jun;123:55-64. doi: 10.1016/j.ypmed.2019.02.023. Epub 2019 Feb 20.
In this nationwide register-based cohort study, we examined cervical cancer screening participation among immigrants in Denmark by country and region of origin. Furthermore, we assessed whether differences in screening participation between immigrants and Danish-born women were explained by sociodemographic or health-related characteristics, and examined predictors of participation among immigrants. Using high-quality registries, we identified women invited for cervical cancer screening during 2008-2009 and retrieved individual-level data on sociodemographic-, health- and immigration-related characteristics. A total of 610,907 women were followed for up to 2.9 years after screening invitation. We estimated the probability of participation using the Aalen-Johansen estimator and the hazard ratios (HRs) of participation using Cox regression. The probability of participation within follow-up was 74.5% (95% CI, 74.4%-74.6%) in Danish-born women; 61.2% (95% CI, 60.4%-62.1%) in Western immigrants; and 61.3% (95% CI, 60.9%-61.8%) in non-Western immigrants. Participation in immigrants varied by region of origin from 44.3% (95% CI, 41.4%-47.4%) in immigrants from North America, New Zealand and Australia to 67.8% (95% CI, 65.4%-70.3%) in immigrants from South- and Central America. Substantial variation was seen between specific countries of origin. Differences in participation between immigrants and Danish-born women were not explained by sociodemographic or health-related characteristics. Predictors of low participation in immigrants included lower income, unemployment, being unmarried, having a history of schizophrenia or other psychoses, and ≤5 years' stay in Denmark. In conclusion, cervical cancer screening participation in immigrants varied by region and country of origin, but all immigrant groups had lower participation than Danish-born women.
在这项全国范围内基于登记的队列研究中，我们按原籍国和地区研究了丹麦移民的宫颈癌筛查参与情况。此外，我们评估了移民与丹麦出生女性之间筛查参与率的差异是否可以用社会人口统计学或与健康相关的特征来解释，并检查了移民参与的预测因素。我们使用高质量的登记册，确定了在 2008-2009 年期间被邀请参加宫颈癌筛查的女性，并检索了与社会人口统计学、健康和移民相关的个体特征数据。共有 610907 名女性在筛查邀请后最多随访 2.9 年。我们使用 Aalen-Johansen 估计器估计参与的概率，并使用 Cox 回归估计参与的风险比 (HR)。在丹麦出生的女性中，随访期间参与的概率为 74.5%（95%CI，74.4%-74.6%）；西方移民为 61.2%（95%CI，60.4%-62.1%）；非西方移民为 61.3%（95%CI，60.9%-61.8%）。移民的参与情况因原籍国/地区而异，从来自北美、新西兰和澳大利亚的移民的 44.3%（95%CI，41.4%-47.4%）到来自南美和中美的移民的 67.8%（95%CI，65.4%-70.3%）。在特定的原籍国之间存在很大的差异。移民与丹麦出生女性之间的参与差异不能用社会人口统计学或与健康相关的特征来解释。移民中低参与率的预测因素包括收入较低、失业、未婚、有精神分裂症或其他精神病病史以及在丹麦居住时间≤5 年。总之，移民的宫颈癌筛查参与情况因原籍国和地区而异，但所有移民群体的参与率均低于丹麦出生的女性。
