Determinants for Participation in Human Papillomavirus Self-Sampling among Nonattenders to Cervical Cancer Screening in Denmark
Menée au Danemark à partir de données socio-démographiques et médicales portant sur 21 314 femmes ne participant pas depuis 4 ou 6 ans au dépistage du cancer du col utérin, puis menée à l'aide de questionnaires auprès de 3 707 d'entre elles (âge : 27 à 65 ans), cette étude identifie les facteurs associés à la participation à un test de recherche du papillomavirus humain avec auto-prélèvement cervico-vaginal (4 743 participantes)
Background : Offering human papillomavirus–based self-sampling to nonparticipants in routine cervical cancer screening can increase screening participation. However, little is known about characteristics of women who accept self-sampling. In this population-based study, we investigated determinants for participation in self-sampling among Danish nonattenders to routine cervical cancer screening.
Methods : During 2014 to 2015, a random sample of screening nonparticipants ages 27 to 65 years living in the Capital Region of Denmark were invited for self-sampling. Of 21,314 eligible women, 4,743 participated in self-sampling. Information on sociodemographic characteristics and mental and physical health of all the women was obtained from nationwide registries, and 3,707 women completed a questionnaire on lifestyle, sexual behavior, and reasons for nonparticipation in routine screening. We used logistic regression to estimate ORs for participation in self-sampling, crude, and adjusted for sociodemographic characteristics.
Results : Basic education [ORadjusted = 0.79; 95% confidence interval (CI), 0.72–0.88], low income (ORadjusted = 0.66; 95% CI, 0.59–0.73), origin from a nonwestern country (ORadjusted = 0.43; 95% CI, 0.38–0.48), and being unmarried (ORadjusted = 0.66; 95% CI, 0.61–0.72) were associated with lower self-sampling participation. Long-term unscreened women (ORadjusted = 0.49; 95% CI, 0.45–0.53), women with prior schizophrenia or other psychoses (ORadjusted = 0.62; 95% CI, 0.48–0.80), women with poor self-perceived health (ORadjusted = 0.42; 95% CI, 0.25–0.69), and women who perceived screening as unnecessary (ORadjusted = 0.54; 95% CI, 0.37–0.80) or irrelevant (ORadjusted = 0.81; 95% CI, 0.78–0.96) were less likely to self-sample.
Conclusions : Certain population groups, including women with low socioeconomic position or of nonwestern origin, were less likely to participate in self-sampling.
Impact : Targeted approaches may be needed to increase screening participation in these groups.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2017