TY - JOUR
T1 - The effect of extended participation windows on attendance at cervical cancer screening
AU - Castañeda, Kelly M.
AU - Sidorenkov, Grigory A.
AU - de Waard, Jolien
AU - Greuter, Marcel J.W.
AU - van der Vegt, Bert
AU - de Kok, Inge M.C.M.
AU - Siebers, Albert G.
AU - Vermeulen, Karin M.
AU - Wisman, G. Bea A.
AU - Schuuring, Ed
AU - de Bock, Geertruida H.
N1 - Funding Information:
This work was supported by The Ministry of Science, Technology, and Innovation of Colombia [PhD call 860 to KMC] and ZonMw [to JW and KMV]. The Lifelines initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG), Groningen University and the Provinces in the North of the Netherlands (Drenthe, Friesland, Groningen). The authors wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers delivering data to Lifelines, and all the study participants. Doctored Ltd ( www.doctored.org.uk ) provided manuscript editing services for the final drafts.
Funding Information:
This work was supported by The Ministry of Science, Technology, and Innovation of Colombia [PhD call 860 to KMC] and ZonMw [to JW and KMV]. The Lifelines initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG), Groningen University and the Provinces in the North of the Netherlands (Drenthe, Friesland, Groningen). The authors wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers delivering data to Lifelines, and all the study participants. Doctored Ltd (www.doctored.org.uk) provided manuscript editing services for the final drafts.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/4
Y1 - 2023/4
N2 - Research has long since confirmed the benefits of regular cervical cancer screening (CCS) worldwide. However, some developed countries have low participation rates despite well-organized screening programs. Given that studies in Europe typically define participation in 12-month windows from an invitation, we evaluated both whether extending this defined time window could reveal the true participation rate and how sociodemographic determinants affect participation delays. This involved linking data from the Lifelines population-based cohort with CCS-related data from the Dutch Nationwide Pathology Databank and including data for 69 185 women eligible for screening in the Dutch CCS program between 2014 and 2018. We then estimated and compared the participation rates for 15- and 36-month time windows and categorized women by the primary screening window into timely participation (within 15 months) and delayed participation (within 15–36 months) groups, before performing multivariable logistic regression to evaluate the association between delayed participation and the sociodemographic determinants. Participation rates for the 15- and 36-month windows were 71.1% and 77.0%, respectively, with participation considered timely in 49 224 cases and delayed in 4047 cases. Delayed participation was associated with age 30–35 years (odds ratio [OR]: 2.88, 95 %CI: 2.67–3.11), higher education (OR: 1.50, 95 %CI: 1.35–1.67), the high-risk human papillomavirus test-based program (OR: 1.67, 95 %CI: 1.56–1.79), and pregnancy (OR: 4.61, 95 %CI: 3.88–5.48). These findings show that a 36-month window for monitoring attendance at CCS better reflects the actual participation rate by accommodating possible delayed uptake among younger, pregnant, and highly educated women.
AB - Research has long since confirmed the benefits of regular cervical cancer screening (CCS) worldwide. However, some developed countries have low participation rates despite well-organized screening programs. Given that studies in Europe typically define participation in 12-month windows from an invitation, we evaluated both whether extending this defined time window could reveal the true participation rate and how sociodemographic determinants affect participation delays. This involved linking data from the Lifelines population-based cohort with CCS-related data from the Dutch Nationwide Pathology Databank and including data for 69 185 women eligible for screening in the Dutch CCS program between 2014 and 2018. We then estimated and compared the participation rates for 15- and 36-month time windows and categorized women by the primary screening window into timely participation (within 15 months) and delayed participation (within 15–36 months) groups, before performing multivariable logistic regression to evaluate the association between delayed participation and the sociodemographic determinants. Participation rates for the 15- and 36-month windows were 71.1% and 77.0%, respectively, with participation considered timely in 49 224 cases and delayed in 4047 cases. Delayed participation was associated with age 30–35 years (odds ratio [OR]: 2.88, 95 %CI: 2.67–3.11), higher education (OR: 1.50, 95 %CI: 1.35–1.67), the high-risk human papillomavirus test-based program (OR: 1.67, 95 %CI: 1.56–1.79), and pregnancy (OR: 4.61, 95 %CI: 3.88–5.48). These findings show that a 36-month window for monitoring attendance at CCS better reflects the actual participation rate by accommodating possible delayed uptake among younger, pregnant, and highly educated women.
KW - Early detection of cancer
KW - Patient compliance
KW - Uterine cervical neoplasms
U2 - 10.1016/j.pmedr.2023.102166
DO - 10.1016/j.pmedr.2023.102166
M3 - Article
C2 - 36926594
AN - SCOPUS:85149229943
SN - 2211-3355
VL - 32
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 102166
ER -