Follow-up after abnormal cervical cancer screening in immigrants compared with Danish-born women – A nationwide register study

• Published in: Preventive medicine 2021-12, Vol.153, p.106776-106776, Article 106776
• Main Authors: Hertzum-Larsen, Rasmus, Kjær, Susanne K., Frederiksen, Kirsten, Thomsen, Louise T.
• Format: Article
• Language: English
• Subjects: Cervical cancer; Follow-up; Immigrants; Migrants; Minorities; Prevention; Public Health; Screening; Socioeconomic position
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2021.106776

Cervical cancer screening is offered free-of-charge to women aged 23–64 years in Denmark. Immigrants participate less in screening than Danish-born women, but little is known about their participation in follow-up after abnormal screening results. In this registry-based cohort study, we examined the likelihood of timely follow-up after an abnormal cervical cytology in immigrants from different countries and regions compared with Danish-born women. In nationwide registers, we identified women aged 23–64 years with high-grade (n = 74,335) or low-grade (n = 174,038) abnormal cytology during 1997–2017. Timely follow-up was defined as a new examination within six months for high-grade and 18 months for low-grade abnormalities. We calculated the probability of timely follow-up by country and region of origin and estimated odds ratios (ORs) of timely follow-up between immigrants and Danish-born women. The proportions with timely follow-up after high-grade abnormalities ranged from 90.6%–95.1% in immigrants from different countries or regions, compared with 95.5% in Danish-born women. For low-grade abnormalities, follow-up ranged from 75.2%–92.8% in immigrants, compared with 90.6% in Danish-born women. Women from Sub-Saharan Africa had low probability of timely follow-up after both high-grade (90.9%) and low-grade (75.2%) abnormalities. The differences between immigrants and Danish-born women remained when adjusting for age, year, income, employment and marital status. In conclusion, immigrants from most countries and regions were slightly less likely than Danish-born women to receive timely follow-up after abnormal cervical cytology, also after adjusting for socioeconomic differences. Efforts should be made to improve follow-up of abnormal screening results in immigrant groups with low attendance. •We studied follow-up after abnormal cervical screening in immigrants vs native women.•Nationwide registry study of abnormal cytologies in Denmark during 1997–2017.•Immigrants from most regions were slightly less likely to receive timely follow-up.•The differences remained when adjusting for socioeconomic position.•Clinicians should ensure timely follow-up of abnormal screening results in immigrants.