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Educational inequalities in cervical cancer screening participation in 24 European countries

A. Altová, I. Kulhánová, K. Reisser, P. Netrdová, J. Brož, TA. Eikemo, M. Balaj, M. Lustigová

. 2024 ; 233 (-) : 1-7. [pub] 20240527

Jazyk angličtina Země Nizozemsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc24019565

OBJECTIVES: Cervical cancer screening (CCS) is an important public health measure for early detection of cervical cancer and prevents a large proportion of cervical cancer deaths. However, participation in CCS is relatively low and varies substantially by country and socio-economic position. This study aimed to provide up-to-date participation rates and estimates on educational inequalities in CCS participation in 24 European countries with population-based CCS programmes. STUDY DESIGN: This was a cross-sectional study. METHODS: Using data from the European Health Interview Survey (EHIS) conducted in 2019, 80,479 women aged 25-64 years were included in the analyses. First, standardized participation rates and standardized participation rates by educational attainment were calculated for all 24 countries based on each country-specific screening programme organization. Second, a series of generalized logistic models was applied to assess the effect of education on CCS participation. RESULTS: Screening participation rates ranged from 34.1% among low-educated women in Romania to 97.1% among high-educated women in Finland. We observed that lower-educated women were less likely to attend CCS than their higher-educated counterparts. Largest educational gaps were found in Sweden (odds ratio [OR] = 6.36, 95% confidence interval [CI] = 3.89-10.35) and Poland (odds ratio = 5.80, 95% CI = 4.34-7.75). CONCLUSION: Population-based screening initiatives have successfully reduced participation differences between women with medium and high educational attainment in some countries; however, persistent disparities still exist between women with low and high levels of education. There is an urgent need to increase participation rates of CCS, especially among lower-educated women.

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$a Educational inequalities in cervical cancer screening participation in 24 European countries / $c A. Altová, I. Kulhánová, K. Reisser, P. Netrdová, J. Brož, TA. Eikemo, M. Balaj, M. Lustigová
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$a OBJECTIVES: Cervical cancer screening (CCS) is an important public health measure for early detection of cervical cancer and prevents a large proportion of cervical cancer deaths. However, participation in CCS is relatively low and varies substantially by country and socio-economic position. This study aimed to provide up-to-date participation rates and estimates on educational inequalities in CCS participation in 24 European countries with population-based CCS programmes. STUDY DESIGN: This was a cross-sectional study. METHODS: Using data from the European Health Interview Survey (EHIS) conducted in 2019, 80,479 women aged 25-64 years were included in the analyses. First, standardized participation rates and standardized participation rates by educational attainment were calculated for all 24 countries based on each country-specific screening programme organization. Second, a series of generalized logistic models was applied to assess the effect of education on CCS participation. RESULTS: Screening participation rates ranged from 34.1% among low-educated women in Romania to 97.1% among high-educated women in Finland. We observed that lower-educated women were less likely to attend CCS than their higher-educated counterparts. Largest educational gaps were found in Sweden (odds ratio [OR] = 6.36, 95% confidence interval [CI] = 3.89-10.35) and Poland (odds ratio = 5.80, 95% CI = 4.34-7.75). CONCLUSION: Population-based screening initiatives have successfully reduced participation differences between women with medium and high educational attainment in some countries; however, persistent disparities still exist between women with low and high levels of education. There is an urgent need to increase participation rates of CCS, especially among lower-educated women.
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$a Kulhánová, I $u Department of Demography and Geodemography, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic; Department of Social Geography and Regional Development, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic
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$a Reisser, K $u Faculty of Medicine, Leipzig University, Liebigstraße, 04103, Leipzig, Germany; Faculty of Health, Medicine, and Life Sciences, Maastricht University, Minderbroedersberg 4-6, 6211 LK Maastricht, the Netherlands
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$a Netrdová, P $u Department of Social Geography and Regional Development, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic
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$a Brož, J $u Department of Internal Medicine, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5, 150 06, Czech Republic
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$a Eikemo, T A $u Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology, Edvard Bulls veg 17049 Trondheim, Norway
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$a Balaj, M $u Global Health Inequalities Research (CHAIN), Department of Sociology and Political Science, Norwegian University of Science and Technology, Edvard Bulls veg 17049 Trondheim, Norway
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$a Lustigová, M $u Department of Social Geography and Regional Development, Faculty of Science, Charles University, Albertov 6, Praha 2, 12800, Czech Republic; National Institute of Public Health, Šrobárova 49/48, Praha 10, 100 00, Czech Republic
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