Cervical screening participation and risk among Swedish-born and immigrant women in Sweden
Cervical screening participation and risk among Swedish-born and immigrant women in Sweden
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DOI：
10.1002/ijc.26084
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发表时间：
2012-02-15
影响因子：
6.4
通讯作者：
Zendehdel, Kazem
中科院分区：
文献类型：
--
作者：
Azerkan, Fatima;Sparen, Par;Zendehdel, Kazem
子宫颈癌是全世界妇女中最常见的癌症之一，尽管子宫颈癌筛查在许多高收入国家降低了发病率。移民妇女的低筛查率可能反映了宫颈癌风险的差异。我们调查了移民和瑞典出生妇女参与子宫颈筛查的程度，以及她们同时患宫颈癌的风险，这是基于从有组织和机会性筛查中获得的子宫颈抹片检查的个人信息。根据出生地区和迁移年龄对1993年至2005年23至60岁妇女的宫颈筛查平均参与程度进行了估计。在泊松回归模型中，我们估计了坚持或不坚持子宫颈筛查计划的妇女宫颈癌的相对风险（rr）、发病率和发病率比。我们还评估了移民群体与瑞典出生的妇女相比，坚持筛查对宫颈癌风险的影响。瑞典出生的妇女和移民妇女的参与程度分别为62%和49%，移民群体之间差异很大。年龄较大的移民参与率最低。瑞典出生和移民的妇女，不坚持子宫颈筛查项目的人患宫颈癌的风险是坚持的妇女的五倍。在对筛查依从性进行调整后，只有挪威和波罗的海国家的妇女宫颈癌的超额rr具有统计学意义。与瑞典出生的妇女相比，移民妇女的筛查参与率较低，坚持推荐的筛查间隔有力地预防了宫颈癌。
Cervical cancer is one of the most common cancers among women worldwide, although cervical screening has reduced the incidence in many high-income countries. Low screening uptake among immigrant women may reflect differences in risk of cervical cancer. We investigated the degree of participation in cervical screening among immigrant and Swedish-born women and their concurrent risk of cervical cancer based on individual information on Pap smears taken both from organized and opportunistic screening. Mean degree of participation in cervical screening was estimated for women between 23 and 60 years from 1993 to 2005, stratified by birth region and age at migration. In Poisson regression models, we estimated relative risks (RRs), incidence rates and incidence rate ratios of cervical cancer for women adhering or not to the cervical screening program. We also assessed effect of adherence to screening on the risk of cervical cancer among immigrant groups compared to Swedish-born women. The degree of participation was 62% and 49% among Swedish-born and immigrant women, respectively, with large variations between immigrant groups. Participation was lowest among those immigrating at older ages. Swedish-born and immigrant women who where nonadherent to the cervical screening program had a fivefold excess risk of cervical cancer compared to adherent women. After adjustment for screening adherence, excess RRs of cervical cancer were statistically significant only for women from Norway and the Baltic States. Participation to screening is lower among immigrant than Swedish-born women, and adherence to the recommended screening intervals strongly prevents cervical cancer.