Cervical cancer testing among women aged 30–49 years in the WHO European Region

Williams, Julianne; Rakovac, Ivo; Victoria, Jocelyn; Татаринова, Т. А.; Corbex, Marilys; Barr, Ben; Rose, Tanith C.; Sturua, Lela; Obreja, Galina; Andreasyan, Diana; Shukurov, Shukhrat; Hagverdiyev, Gahraman; Mikkelsen, Bente; Berdzuli, Nino; Breda, João

doi:10.1093/eurpub/ckab100

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…Cervical cancer screening services are globally endorsed as an effective measure for preventing the second most common cancer in women. However, the utilization of these services exhibits significant disparities worldwide, with lower-income countries having a smaller share of coverage [ 6 ]. Screening coverage varies widely, with rates reported at approximately 78% in Spain and England, 98% in Finland, 65.6% in Korea, and 62% in Botswana [ 15 , 16 , 26 – 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Papanicolaou cervical screening method has been instrumental in preventing a substantial proportion of cervical cancers since its introduction [ 4 ]. While widely recommended for detecting precancerous lesions [ 5 ], its effectiveness has been less pronounced in lower-income countries [ 6 ]. Reports from various regions illustrate disparate uptake rates, such as less than 5 percent in Uganda [ 7 ], around 31 percent in Jordan [ 8 ], approximately 27 percent in Malaysia [ 9 ], and 35 percent among Lebanese women [ 10 ].…”

Section: Background/introductionmentioning

confidence: 99%

“…Reports from various regions illustrate disparate uptake rates, such as less than 5 percent in Uganda [ 7 ], around 31 percent in Jordan [ 8 ], approximately 27 percent in Malaysia [ 9 ], and 35 percent among Lebanese women [ 10 ]. Notably, rates range from less than 30 percent in Georgia, Azerbaijan, Tajikistan, and Uzbekistan to approximately 100 percent in Finland [ 6 ].…”

Section: Background/introductionmentioning

confidence: 99%

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Socioeconomic disparities in Papanicolaou test utilization in Western Iran

Safari-Faramani,

Najafi

et al. 2024

BMC Public Health

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Background Cervical cancer remains the fourth most frequently diagnosed cancer among women, and its impact is particularly significant in women residing in less developed countries. This study aims to assess socioeconomic inequality in using Papanicolaou tests, commonly known as Pap tests, which are crucial for detecting cervical cancer. The research also seeks to decompose this inequality, identifying its contributing factors. This investigation is conducted within a sizable population-based study focused on the Kurdish population, with an additional examination of potential variations between urban and rural areas. Method The study utilized baseline data from the Ravansar Non-Communicable Disease Cohort Study (RaNCD), involving 3,074 ever-married women aged 35–65. Asset data was employed to determine socioeconomic status (SES), and Principal Component Analysis was applied. The uptake of Papanicolaou tests was assessed for inequality using the Concentration Index (Cn). Additionally, decomposition analysis was conducted to identify and understand the factors contributing to socioeconomic inequality. Results The study found that overall, 86% of women reported having undergone cervical cancer screening at least once in their lifetime. The Concentration Index (Cn) for the total population was 0.21 (p < 0.0001), indicating a higher concentration of Papanicolaou test uptake among wealthier groups. In urban areas, the Cn was 0.34 (p < 0.0001), reflecting a significant concentration among the rich. However, in rural areas, the Cn was -0.10 (p = 0.3006), suggesting no significant socioeconomic inequality. Factors such as socioeconomic status (SES), education, and age contributed to reducing inequality, explaining 62.7%, 36.0%, and 1.7% of the observed inequality, respectively. Interestingly, place of residence had a negative influence on inequality. Conclusion The uptake of Papanicolaou tests varies across different socioeconomic status levels, with a higher concentration among wealthier groups. The results enable health policymakers and researchers to tailor health intervention toward increasing public awareness, especially among women with lower levels of education women in economically deprived groups.

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Section: Discussionmentioning

confidence: 99%

Section: Background/introductionmentioning

confidence: 99%

Section: Background/introductionmentioning

confidence: 99%

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Socioeconomic disparities in Papanicolaou test utilization in Western Iran

Safari-Faramani,

Najafi

et al. 2024

BMC Public Health

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“…First, the non-response rate was high (approximately 50%), which might have resulted in non-response bias. Furthermore, biases such as response bias, recall bias, social or cultural acceptability, ambiguity about the performed test, and decreased inclusion of women from vulnerable groups may occur in survey-based studies [22]. These limitations can only be overcome by implementing high-quality data registration in a national cervical screening registry.…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 99%

Self-reported participation in cervical cancer screening among Polish women in 2004–2019

Michalek,

Manczuk,

Caetano dos Santos

et al. 2023

Ginekol Pol

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Objectives:We aimed to assess self-reported participation in cervical cancer screening among Polish women between 2004 and 2019 and to identify the groups with the lowest participation rate.Material and methods: Data on declared participation in cervical cancer screening were obtained from the European Health Interview Survey from 2004 to 2019. Results:In 2019, 86.7% of Polish women aged ≥ 15 years declared that they had ever undergone a Pap test. Compared to 2004, the coverage of ever-screened women improved by 16.6 percentage points. The proxy population coverage was 72.9%. The highest proportion of women who underwent a Pap smear in the last three years was observed among those aged 35-44 years and 25-34 years (84.0% and 83.2%, respectively), and the lowest among women aged ≥ 75 years (20.5%). The proportion screened within the last three years also varied by education (up to lower secondary education 26.4%, up to post-secondary non-tertiary education 62.8%, and the highest level of education 83.7%), urbanization (large cities 66.7%, suburbs, and smaller cities 62.8%, and rural areas 59.0%), income (poorest households 42.5%, wealthiest households 70.6%), and declared health status (best 68.9%, worst 41.4%). The lowest participation in screening was observed in the southeastern regions and the highest in the northwestern regions of Poland Conclusions: In Poland, in 2019, the approximate coverage of cervical cancer screening was high compared to other European countries and has improved over the last 15 years. A complete screening registry is required to confirm questionnaire-based self-reported data. Targeted interventions should be implemented to address low participation in the identified regions and socioeconomic groups.

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“…In Europe, screening and treating early neoplasia have substantially reduced the incidence and mortality of cervical cancer since 1960 [ 2 – 5 ]. In this area in 2021, rates of women aged 30–49 who reported ever having had a cervical cancer test varied from 42.0% (in Romania) to 98.4% in Finland, according to the WHO [ 6 ].In other high-income countries, rates were higher: 88% in the USA, 91% in Canada, and 95% in Australia had ever undergo Pap tests [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Women’s country of birth and failure to catch up an overdue cervical cancer cytological screening participation during pregnancy in France, an observational study based on survey sources

Lyonnais,

Vigoureux,

Blondel

et al. 2024

BMC Cancer

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Background Cervical cancer is the fourth most common cancer among women worldwide, both for incidence and mortality. Prevention relies on screening with a Pap test to detect precancerous lesions, which can then be treated. Access to this screening is currently both improvable and inequitable. Pregnancy may be an ideal moment for women to catch up on their overdue cervical cancer screening. In the general population, women's risk of not being screened is associated with their place of birth and other social factors; this may be true as well among pregnant women. Our objective was to study the association between women's place of birth and their failure to catch up with this screening during pregnancy. Methods The 2016 French National Perinatal Survey included 13,147 women who gave birth after 21 weeks of gestation. The association between their place of birth and failure to catch up on this screening (defined by the absence of a Pap test during pregnancy for women overdue for it) was adjusted for age, parity, education level, health insurance, and when they began prenatal care with logistic regression models. Results Among the women for whom screening was then recommended, 49% were not up to date at the start of pregnancy, and of these, 53% were not caught up before delivery. After adjustment for other risk factors, maternal place of birth was not associated with a higher risk of failure to catch up with this screening during pregnancy. However, factors identified as associated with this risk included a low education level and late start of prenatal care. Conclusion About half of women overdue for cervical cancer screening did not catch up with it during their pregnancy. Professionals should pay special attention to women with lower education levels and late initiation of prenatal care, who constitute a group at high risk of not catching up on this screening during pregnancy.

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Cervical cancer testing among women aged 30–49 years in the WHO European Region

Cited by 9 publications

References 17 publications

Socioeconomic disparities in Papanicolaou test utilization in Western Iran

Socioeconomic disparities in Papanicolaou test utilization in Western Iran

Self-reported participation in cervical cancer screening among Polish women in 2004–2019

Women’s country of birth and failure to catch up an overdue cervical cancer cytological screening participation during pregnancy in France, an observational study based on survey sources

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