Participation in the nation-wide cervical cancer screening programme in Denmark during the COVID-19 pandemic: an observational study
- The Danish Clinical Quality Program - National Clinical Registries, Denmark
- University of Southern Denmark, Denmark
- Randers Regional Hospital, Denmark
Abstract
Background: In contrast to most of the world, the cervical cancer screening programme continued in Denmark throughout the COVID-19 pandemic. We examined the cervical cancer screening participation during the pandemic in Denmark.
Methods: We included all women aged 23-64 years old invited to participate in cervical cancer screening from 2015-2021 as registered in the Cervical Cancer Screening Database combined with population-wide registries. Using a generalised linear model, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) of cervical cancer screening participation within 90, 180 and 365 days since invitation during the pandemic in comparison with the previous years adjusting for age, year and month of invitation.
Results: Altogether, 2,220,000 invited women (in 1,466,353 individuals) were included in the study. Before the pandemic, 36% of invited women participated in screening within 90 days, 54% participated within 180 days and 65% participated within 365 days. At the start of the pandemic, participation in cervical cancer screening within 90 days was lower (pre-lockdown PR=0.58; 95% CI: 0.56-0.59 and 1st lockdown PR=0.76; 95% CI: 0.75-0.77) compared with the previous years. A reduction in participation within 180 days was also seen during pre-lockdown (PR=0.89; 95% CI: 0.88-0.90) and 1st lockdown (PR=0.92; 95% CI: 0.91-0.93). Allowing for 365 days to participation, only a slight reduction (3%) in participation was seen with slightly lower participation in some groups (immigrants, low education and low income).
Conclusions: The overall participation in cervical cancer screening was reduced during the early phase of the pandemic. However, the decline almost diminished with longer follow-up time.
Funding: The study was funded by the Danish Cancer Society Scientific Committee (grant number R321-A17417) and the Danish regions.
Data availability
Data availability statementIn order to comply with the Danish regulations on data privacy, the datasets generated and analysed during this project are not publicly available as the data are stored and maintained electronically at Statistics Denmark, where it only can be accessed by pre-approved researchers using a secure VPN remote access. Furthermore, no data at a personal level nor data not exclusively necessary for publication are allowed to be extracted from the secure data environment at Statistics Denmark. Access to the data can; however, be granted by the authors of the present study upon a reasonable scientific proposal within the boundaries of the present project and for scientific purposes only.
Article and author information
Author details
Funding
The Danish Cancer Society (R321-A17417)
- Tina Bech Olesen
- Henrik Møller
The Danish regions
- Tina Bech Olesen
- Henry Jensen
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: Ethical considerationsThe study is registered at the Central Denmark Region's register of research projects (journal number 1-16-02-381-20). Patient consent is not required by Danish law for register-based studies.
Copyright
© 2023, Olesen et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Participation in the nation-wide cervical cancer screening programme in Denmark during the COVID-19 pandemic: an observational study
eLife 12:e81522.
https://doi.org/10.7554/eLife.81522
