Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Prev Med. 2021 Dec;153:106776. doi: 10.1016/j.ypmed.2021.106776. Epub 2021 Aug 24.
Cervical cancer screening is offered free-of-charge to women aged 23-64 years in Denmark. Immigrants participate less in screening than Danish-born women, but little is known about their participation in follow-up after abnormal screening results. In this registry-based cohort study, we examined the likelihood of timely follow-up after an abnormal cervical cytology in immigrants from different countries and regions compared with Danish-born women. In nationwide registers, we identified women aged 23-64 years with high-grade (n = 74,335) or low-grade (n = 174,038) abnormal cytology during 1997-2017. Timely follow-up was defined as a new examination within six months for high-grade and 18 months for low-grade abnormalities. We calculated the probability of timely follow-up by country and region of origin and estimated odds ratios (ORs) of timely follow-up between immigrants and Danish-born women. The proportions with timely follow-up after high-grade abnormalities ranged from 90.6%-95.1% in immigrants from different countries or regions, compared with 95.5% in Danish-born women. For low-grade abnormalities, follow-up ranged from 75.2%-92.8% in immigrants, compared with 90.6% in Danish-born women. Women from Sub-Saharan Africa had low probability of timely follow-up after both high-grade (90.9%) and low-grade (75.2%) abnormalities. The differences between immigrants and Danish-born women remained when adjusting for age, year, income, employment and marital status. In conclusion, immigrants from most countries and regions were slightly less likely than Danish-born women to receive timely follow-up after abnormal cervical cytology, also after adjusting for socioeconomic differences. Efforts should be made to improve follow-up of abnormal screening results in immigrant groups with low attendance.
丹麦为 23-64 岁的女性提供免费的宫颈癌筛查。移民参与筛查的比例低于丹麦出生的女性，但对于他们在异常筛查结果后的后续参与情况知之甚少。在这项基于登记的队列研究中，我们比较了来自不同国家和地区的移民与丹麦出生的女性在异常宫颈细胞学检查后的及时随访可能性。我们在全国性登记册中确定了 1997-2017 年间患有高级别（n=74335）或低级别（n=174038）异常细胞学的 23-64 岁女性。及时随访定义为高级别异常的 6 个月内和低级别异常的 18 个月内进行新检查。我们按原籍国和地区计算了及时随访的概率，并估计了移民与丹麦出生女性之间及时随访的比值比（OR）。来自不同国家或地区的移民中，及时随访高级别异常的比例为 90.6%-95.1%，而丹麦出生女性为 95.5%。对于低级别异常，移民中及时随访的比例为 75.2%-92.8%，而丹麦出生女性为 90.6%。来自撒哈拉以南非洲的女性在高级别（90.9%）和低级别（75.2%）异常后及时随访的可能性较低。调整年龄、年份、收入、就业和婚姻状况后，移民与丹麦出生女性之间的差异仍然存在。总之，大多数国家和地区的移民在接受异常宫颈细胞学检查后的及时随访的可能性略低于丹麦出生的女性，即使在调整了社会经济差异后也是如此。应努力改善低出勤率移民群体异常筛查结果的随访。
