Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018)

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...

Full description

Saved in:
Bibliographic Details
Main Authors: Filip Jansåker, Xinjun Li, Avalon Sundqvist, Kristina Sundquist, Christer Borgfeldt
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Acta Obstetricia et Gynecologica Scandinavica
Subjects:
Online Access:https://doi.org/10.1111/aogs.14480
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:0001-6349
1600-0412