Determinants for Participation in Human Papillomavirus Self-Sampling among Nonattenders to Cervical Cancer Screening in Denmark

TY - JOUR

T1 - Determinants for Participation in Human Papillomavirus Self-Sampling among Nonattenders to Cervical Cancer Screening in Denmark

AU - Harder, Elise

AU - Thomsen, Louise T

AU - Hertzum-Larsen, Rasmus

AU - Albieri, Vanna

AU - Hessner, Marie Vik

AU - Juul, Kirsten Egebjerg

AU - Bonde, Jesper

AU - Frederiksen, Kirsten

AU - Kjaer, Susanne K

N1 - ©2018 American Association for Cancer Research.

PY - 2018/11

Y1 - 2018/11

N2 - 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 [ORadjusted1/40.79; 95% confidence interval (CI), 0.72-0.88], low income (ORadjusted1/40.66; 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, 0.250.69), 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, includingwomen 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.

AB - 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 [ORadjusted1/40.79; 95% confidence interval (CI), 0.72-0.88], low income (ORadjusted1/40.66; 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, 0.250.69), 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, includingwomen 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.

U2 - 10.1158/1055-9965.epi-18-0480

DO - 10.1158/1055-9965.epi-18-0480

M3 - Journal article

C2 - 30108095

SN - 1055-9965

VL - 27

SP - 1342

EP - 1351

JO - Cancer Epidemiology, Biomarkers & Prevention

JF - Cancer Epidemiology, Biomarkers & Prevention

IS - 11

ER -