Enden Marta Røttingen, Møen Kathy, Igland Jannicke, Diaz Esperanza
Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway.
Scand J Public Health. 2024 Dec;52(8):927-933. doi: 10.1177/14034948231217636. Epub 2024 Jan 2.
Immigrant women in Norway have lower cervical cancer screening participation than non-immigrant women. Our aim in this study was to assess whether the observed increase in screening participation during 2012-2017 was different between Norwegian-born women and immigrant women.
Data were collected from three national registries. The study included 1,409,561 women, categorized according to country of birth and immigrant background: (i) Norway, Norwegian parents; (ii) Norway, immigrant parent(s); (iii) Europe, excluding Norway; (iv) Africa; (v) Asia, including Turkey; and (vi) other countries. Trends and differences between groups were analyzed using Poisson regression analyses with adjustments for variables other studies have found to influence screening participation. Trends were assessed by including half-years as a continuous variable in the models and reported as prevalence ratios with 95% confidence intervals.
Screening participation increased in all groups, but was not statistically significant among women from Africa in the adjusted model. The highest increase was among Norwegian women, with a 2.2% increase per year. Interaction tests showed significantly smaller increases in screening among women born in Europe ( interaction < 0.0001), Africa ( interaction < 0.0001), Asia ( interaction < 0.0001), and countries in the "Other" category ( interaction = 0.004). There was also a smaller increase among Norwegian-born women with one or more immigrant parent(s), but this was not significant ( interaction = 0.178).
The gap in screening participation and the increasing differences in trends suggest that healthcare services do not reach all women in Norway to the same extent. One should attempt to improve this while working toward further increasing screening participation for all.
挪威的移民女性宫颈癌筛查参与率低于非移民女性。本研究的目的是评估2012年至2017年期间观察到的筛查参与率上升在挪威出生的女性和移民女性之间是否存在差异。
数据来自三个国家登记处。该研究纳入了1409561名女性，根据出生国家和移民背景进行分类：(i)挪威，父母为挪威人；(ii)挪威，父母一方或双方为移民；(iii)欧洲（不包括挪威）；(iv)非洲；(v)亚洲（包括土耳其）；以及(vi)其他国家。使用泊松回归分析对组间趋势和差异进行分析，并对其他研究发现会影响筛查参与率的变量进行调整。通过将半年作为模型中的连续变量来评估趋势，并以95%置信区间的患病率比进行报告。
所有组的筛查参与率均有所上升，但在调整模型中，非洲女性的上升无统计学意义。上升幅度最大的是挪威女性，每年上升2.2%。交互检验显示，出生在欧洲（交互作用<0.0001）、非洲（交互作用<0.0001）、亚洲（交互作用<0.0001）以及“其他”类别国家（交互作用=0.004）的女性筛查率的上升显著较小。父母一方或双方为移民的挪威出生女性的上升幅度也较小，但不显著（交互作用=0.178）。
筛查参与率的差距以及趋势上日益增大的差异表明，挪威的医疗服务并未以相同程度覆盖所有女性。在努力进一步提高所有女性的筛查参与率的同时，应尝试改善这种情况。
