Dataset Information

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 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.

SUBMITTER: Jansaker F

PROVIDER: S-EPMC9780723 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

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

Jansåker Filip F Li Xinjun X Sundqvist Avalon A Sundquist Kristina K Borgfeldt Christer C

Acta obstetricia et gynecologica Scandinavica 20221104 1

<h4>Introduction</h4>Cervical cancer is a major cause of mortality and morbidity. We aimed to estimate the association between sociodemographic factors and cervical neoplasia.<h4>Material and methods</h4>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 le ...[more]

PMID: 36330802

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Project description:BackgroundCervical cancer is a major cause of mortality and morbidity in women worldwide. This study aimed to estimate the association between common urogenital infections and cervical neoplasia.MethodsA multi-register national cohort study of 4,120,557 women aged ≥15 years (2002-2018) was conducted. The outcomes were cervical cancer and carcinoma in situ (Swedish Cancer Register). The main predictors were urogenital infections-(urinary) cystitis, (bacterial) vaginosis, (candida) vulvovaginitis. Incidence rates per 10,000 person-years were calculated (using the European Standard Population). Cox regression was used to estimate hazard ratios (HR) while adjusting for possible confounders-other genital infections (e.g., cervicitis, salpingitis, urogenital herpes), parity, and sociodemographic factors.FindingsIn 39·0 million person-years of follow-up, the incidence rate for cervical cancer was 1·2 (95% CI 1·1-1·2) per 10,000 person-years and the figure for cervical carcinoma in situ was more than tenfold higher. The fully adjusted HRs for cervical cancer were 1·31 (95% CI 1·15 and 1·48) and 1·22 (95% CI 1·16 and 1·29) for vaginosis and cystitis, respectively. Vaginosis showed a gradient association to carcinoma in situ. Vulvovaginitis was inversely associated with cervical cancer, but not significantly related with carcinoma in situ in the fully adjusted model. A temporal association with cervical cancer was observed for vaginosis and vulvovaginitis (inversely) but not for cystitis.InterpretationIn this large nationwide cohort of women, medically attended common urogenital infections were independently associated with cervical neoplasia, but cystitis was not temporally associated with cervical neoplasia. These findings could be used to increase focus on preventive measures, HPV-vaccination programmes, HPV-analyses- and cervical cancer screening, especially in women suffering from vaginosis. Future studies on the causal mechanism are warranted before generalized public health recommendations can be made.FundingRegion Skåne, Tore Nilsons Stiftelse, and Swedish Society of Medicine.

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Project description:BACKGROUND:The main objective of the study is to analyse the changes in the prevalence of obesity among Czech adolescents between 2002 and 2018 with regard to the socioeconomic status (SES) of adolescents' families and to find SES-separated correlates of adolescents' obesity in 2018. METHODS:A nationally representative sample of 29,879 adolescents (49.6% of them boys) aged 10.5-16.5?years was drawn from the Health Behaviour in School-aged Children cross-sectional, self-reported questionnaire surveys conducted in 2002, 2006, 2010, 2014, and 2018 in Czechia. Chi-square (?2) tests were performed to assess the changes in the prevalence of obesity in both genders and all SES categories of adolescents between 2002 and 2018, and SES category-related differences in the prevalence of obesity in 2018 separately for boys and girls. A series of multiple stepwise logistic regression (backward elimination) analyses were used to reveal obesity correlates separately for SES categories of adolescents. RESULTS:Across the quadrennial surveys from 2002 to 2018, we observed a clear increase in the prevalence of obesity in all SES categories of adolescents, which was most striking (p <?0.05) in adolescents with low SES (boys: +?7.5% points (p.p.); girls +?2.4 p.p.). When all the survey cycles were compared, the highest prevalence of obesity was evident in the low-SES adolescents in 2018, both in girls (5.1%) and boys (12.0%). Regardless of the adolescent SES category, the lower odds of obesity were significantly (p?<?0.05) associated with regular vigorous physical activity (PA), participation in organized sport, and daily consumption of sweets. In addition, at least 60?min of moderate-to-vigorous PA significantly reduced the odds of obesity in adolescents of low and high SES categories. CONCLUSIONS:An unreasonable increase in the prevalence of obesity in adolescents with low SES highlights the need to prevent obesity in adolescents with a low-SES background. Additionally, significantly higher odds of obesity in 11- and 13-year-old adolescents from low-SES families, compared with their peers aged 15, indicated an expectable rise in obesity in older low-SES adolescents in the near future.

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Dataset Information

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

Introduction

Material and methods

Results

Conclusions

Publications

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

Similar Datasets

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