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...
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Wiley
2023-01-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14480 |
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| author | Filip Jansåker Xinjun Li Avalon Sundqvist Kristina Sundquist Christer Borgfeldt |
| author_facet | Filip Jansåker Xinjun Li Avalon Sundqvist Kristina Sundquist Christer Borgfeldt |
| author_sort | Filip Jansåker |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-893d0cd1d67a40319f267e29642864ae |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-893d0cd1d67a40319f267e29642864ae2025-08-20T02:09:35ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-01-01102111412110.1111/aogs.14480Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018)Filip Jansåker0Xinjun Li1Avalon Sundqvist2Kristina Sundquist3Christer Borgfeldt4Center for Primary Health Care Research, Department of Clinical Sciences Malmö Lund University Lund SwedenCenter for Primary Health Care Research, Department of Clinical Sciences Malmö Lund University Lund SwedenDepartment of Obstetrics and Gynecology, Skåne University Hospital, Department of Clinical Science Lund Lund University Lund SwedenCenter for Primary Health Care Research, Department of Clinical Sciences Malmö Lund University Lund SwedenDepartment of Obstetrics and Gynecology, Skåne University Hospital, Department of Clinical Science Lund Lund University Lund SwedenAbstract 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.https://doi.org/10.1111/aogs.14480cervical cancercervical neoplasiaepidemiologyparitysociodemographic factors |
| spellingShingle | Filip Jansåker Xinjun Li Avalon Sundqvist Kristina Sundquist Christer Borgfeldt Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018) Acta Obstetricia et Gynecologica Scandinavica cervical cancer cervical neoplasia epidemiology parity sociodemographic factors |
| title | Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018) |
| title_full | Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018) |
| title_fullStr | Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018) |
| title_full_unstemmed | Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018) |
| title_short | Cervical neoplasia in relation to socioeconomic and demographic factors – a nationwide cohort study (2002–2018) |
| title_sort | cervical neoplasia in relation to socioeconomic and demographic factors a nationwide cohort study 2002 2018 |
| topic | cervical cancer cervical neoplasia epidemiology parity sociodemographic factors |
| url | https://doi.org/10.1111/aogs.14480 |
| work_keys_str_mv | AT filipjansaker cervicalneoplasiainrelationtosocioeconomicanddemographicfactorsanationwidecohortstudy20022018 AT xinjunli cervicalneoplasiainrelationtosocioeconomicanddemographicfactorsanationwidecohortstudy20022018 AT avalonsundqvist cervicalneoplasiainrelationtosocioeconomicanddemographicfactorsanationwidecohortstudy20022018 AT kristinasundquist cervicalneoplasiainrelationtosocioeconomicanddemographicfactorsanationwidecohortstudy20022018 AT christerborgfeldt cervicalneoplasiainrelationtosocioeconomicanddemographicfactorsanationwidecohortstudy20022018 |