Participation in the nationwide cervical cancer screening programme in Denmark during the COVID-19 pandemic: An observational study

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.

Nationwide mammography screening participation in Denmark during the COVID-19 pandemic: An observational study

“…This indicates that the restrictions imposed in Denmark may have affected some groups of women disproportionally. A study from Spain Bosch et al, 2022 found that the participation in mammography screening decreased with age and with lower socio-economic level post-COVID-19; this has also been reported for the two other screening programmes in Denmark ( Olesen et al, 2023a ; Olesen et al, 2023b ; this study). The evidence is scarce on participation according to ethnicity throughout the pandemic; however, the lower participation during the pandemic has also been demonstrated for bowel and cervical cancer screening in Denmark ( Olesen et al, 2023a ; Olesen et al, 2023b ; this study).…”

“…A study from Spain Bosch et al, 2022 found that the participation in mammography screening decreased with age and with lower socio-economic level post-COVID-19; this has also been reported for the two other screening programmes in Denmark ( Olesen et al, 2023a ; Olesen et al, 2023b ; this study). The evidence is scarce on participation according to ethnicity throughout the pandemic; however, the lower participation during the pandemic has also been demonstrated for bowel and cervical cancer screening in Denmark ( Olesen et al, 2023a ; Olesen et al, 2023b ; this study). Immigrants may find it more difficult to navigate the healthcare system in Denmark, and possibly this has been exacerbated by the pandemic where the majority of the communication at press conferences and news media were conveyed in Danish, a language that may not be fully comprehensive to all immigrants.…”

“…However, the participation in screening for cervical and bowel cancer in Denmark during the pandemic showed similar patterns, with a decrease in the short term, but to a much lesser extent in the longer term. This indicates that people invited for screening in Denmark more often postponed their participation by a few months, rather than not attending at all ( Olesen et al, 2023a ; Olesen et al, 2023b ; this study).…”

Nationwide participation in FIT-based colorectal cancer screening in Denmark during the COVID-19 pandemic: An observational study

“…We found an overall 5–10% increased participation in colorectal cancer screening from first re-opening and onwards. We did not find an increased participation in the other cancer screening programmes (breast and cervical cancer) in Denmark ( Olesen et al, 2023 ; Olesen et al, 2022 ) most likely because those programmes require contact with the healthcare system. A home-based self-collected screening sample thus appear to work well during a pandemic, which could be used in other programmes, for example, cervical cancer screening.…”

Diagnosis and Incidence of Congenital Combined Pituitary Hormone Deficiency in Denmark—A National Observational Study

“…Through the ICD-10 diagnosis code searches and the subsequent hospital file reviews, we identified 114 patients through the DNPR search and 14 patients through the tertiary hospital registries, resulting in a national cCPHD cohort of 128 patients (Table S1 ( 23 )). Of these, 116 were born in Denmark and diagnosed before age 18 years, representing the national incidence cohort of cCPHD diagnosed <18 years ( Fig.…”