Predictors of non-participation in cervical screening in Denmark.
OBJECTIVE
The aims of this study were to identify demographic and socio-economic predictors of non-participation in cervical screening in Denmark, and to evaluate the influence of health care use on screening participation.


METHODS
A population based register study was undertaken using data from the Central Population Register, the national Patobank, and Statistics Denmark. The study included women aged 25-54 years on 1st of January 2002, living in Denmark during the next 5 years, and without a history of total hysterectomy, N=1,052,447. Independent variables included age, civil status, nationality, level of education, and use of health care. Associations with non-participation in screening were determined with logistic regression.


RESULTS
Main predictors of non-participation were limited or no contact with dental services (odds ratio (OR)=2.36), general practitioners (OR=1.75), and high age (OR=1.98). Other important factors for non-participation were primary school education only (OR=1.53), not being married (OR=1.49), and foreign nationality (OR=1.32).


CONCLUSIONS
A 2-1.5-fold difference in non-participation in cervical screening in Denmark was found across various population sub-groups. Increased screening compliance among women with primary school education only, and limited or no use of primary health care services in general could potentially diminish the current social inequalities in cervical cancer incidence, and thus decrease the overall high incidence of this disease in Denmark.
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark. Electronic address: jenny.h.kristensson@gmail.com.
Jenny Hansen
JH
Kristensson
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark. Electronic address: bbsa@sund.ku.dk.
Bente Braad
BB
Sander
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark. Electronic address: myeu@sund.ku.dk.
My
M
von Euler-Chelpin
Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark. Electronic address: elsebeth@sund.ku.dk.
Elsebeth
E
Lynge
D000328:Adult; D003718:Denmark / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data*; D012042:Registries; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology*
Denmark; Health behavior; Mass screening; Socioeconomic factors; Uterine cervical neoplasms