Eslahi Marzieh, Pizzato Margherita, Heikkinen Sanna, Martinsen Jan Ivar, Lynge Elsebeth, Hansen Johnni, Selander Jenny, Mehlum Ingrid Sivesind, Pukkala Eero, Vaccarella Salvatore
International Agency for Research on Cancer, Lyon, France.
Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy.
Int J Cancer. 2025 Jul 1;157(1):95-102. doi: 10.1002/ijc.35349. Epub 2025 Mar 13.
The Nordic countries benefited from declines in cervical cancer incidence rates due to the implementation of screening programmes. However, it is unclear whether all social groups have equally benefited from these preventive services. We provide an assessment of the temporal trends in cervical cancer incidence by socioeconomic position (SEP) in Denmark, Norway, Finland and Sweden, using data from the Nordic Occupational Cancer Study. Truncated age-standardized incidence rates and 95% confidence intervals (CI) of cervical cancer per 100,000 person-years were computed for women aged 50-69 by SEP and country within the period 1961-2005. We used Poisson regression models to compute relative risks (RRs) and 95% CIs of cervical cancer across SEP, pooling data for the three most recent 5-year periods (except for Denmark 1991-1995 and Norway 1991-2003). Throughout the study period, declines in the rates of cervical cancer were observed among all SEP groups. Lower SEP rates, which started from higher values, declined faster than those for higher SEP. At the conclusion of the study period, we still observed a social gradient, with higher rates seen in lower SEP women. Farmers had the lowest risk in all four countries. The RRs for lowest versus highest SEP ranged from 1.33 (95% CI 1.05-1.69) in Sweden to 1.76 (95% CI 1.13-2.85) in Denmark, with a pooled RR of 1.41 (95% CI 1.22-1.64). Lower SEP women still face the highest risks, indicating a need for continued efforts to provide equitable access to preventive services.
由于实施了筛查计划，北欧国家宫颈癌发病率有所下降。然而，尚不清楚所有社会群体是否都同样从这些预防服务中受益。我们利用北欧职业癌症研究的数据，对丹麦、挪威、芬兰和瑞典宫颈癌发病率按社会经济地位（SEP）的时间趋势进行了评估。计算了1961年至2005年期间按SEP和国家划分的50至69岁女性每10万人年的宫颈癌截断年龄标准化发病率及95%置信区间（CI）。我们使用泊松回归模型计算不同SEP水平下宫颈癌的相对风险（RRs）及95%CI，汇总了最近三个5年期间的数据（丹麦1991 - 1995年和挪威1991 - 2003年除外）。在整个研究期间，所有SEP组的宫颈癌发病率均呈下降趋势。起始值较高的低SEP组发病率下降速度快于高SEP组。在研究期结束时，我们仍观察到社会梯度，低SEP女性的发病率更高。在所有四个国家中，农民的风险最低。最低SEP与最高SEP的RRs范围从瑞典的1.33（95%CI 1.05 - 1.69）到丹麦的1.76（95%CI 1.13 - 2.85），合并RR为1.41（95%CI 1.22 - 1.64）。低SEP女性仍然面临最高风险，这表明需要继续努力提供公平的预防服务获取途径。
