Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018). (4th November 2022)

• Record Type: Journal Article
• Authors: Jansåker, Filip; Li, Xinjun; Sundqvist, Avalon; Sundquist, Kristina; Borgfeldt, Christer
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 102:Number 1(2023)
• Page Start: 114
• Page End: 121
• Publication Date: 2022-11-04
• Subjects: cervical cancer -- cervical neoplasia -- epidemiology -- parity -- sociodemographic factors; Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.14480
• Languages: English
• ISSNs: 0001-6349

Abstract

Abstract: Introduction: Cervical cancer is a major cause of mortality and morbidity. We aimed to estimate the association between sociodemographic factors and cervical neoplasia. Material and methods: In this Swedish nationwide open cohort study, 4 120 557 women aged ≥15 years at baseline were included between January 1, 2002 and December 31, 2018. The two outcomes were cervical cancer and carcinoma in situ identified in the Swedish Cancer Register. Sociodemographic factors (age, education level, family income level, region of residency, country of origin) were the main predictors. Incidence rates per 10 000 person‐years were calculated. Cox regression was used to estimate hazard ratios. Sensitivity analyses were conducted, including parity, urogenital infections, alcohol‐ and drug‐use disorders, and chronic obstructive pulmonary disease (used as a proxy for tobacco abuse). Results: In 38.9 million person‐years of follow‐up, 5781 (incidence rate: 1.5, 95% confidence interval [CI] 1.4–1.5) and 62 249 (incidence rate 16.9, 95% CI 15.9–16.1) women were diagnosed with cervical cancer and carcinoma in situ, respectively. Women from Eastern Europe had a hazard ratio of 1.18 (95% CI 1.05–1.33) for cervical cancer compared with Swedish‐born women, while women from non‐Western regions were inversely associated with cervical cancer and carcinoma in situ. Women with a low education level had a hazard ratio of 1.37 (95% CI 1.29–1.45) for cervical cancer compared with women with a high education level. Conclusions: Women from the Middle East and Africa living in Sweden seem to suffer less from cervical neoplasia, whereas women with low education and women from Eastern Europe seem to suffer more from cervical cancer. Abstract : Women of low education level and Eastern European origin seem to suffer disproportionately from cervical cancer, while women from other regions (especially Middle East and Africa) appear to be less affected. The findings can be used in cancer prevention.