Cervical human papillomavirus prevalence according to socioeconomic and demographic characteristics in a large Danish screening population.

ABSTRACT

AIM: The aim of this study was to investigate high-risk human papillomavirus (hrHPV) prevalence according to socioeconomic and demographic characteristics in a Danish screening population. METHODS: We used data from HPV SCREEN DENMARK, which was an implementation study embedded into the routine cervical cancer screening programme. During 2017-2020, women aged 30-59 years screened in the Region of Southern Denmark were offered HPV testing or cytology. In the HPV group, liquid-based cytology samples were tested for 14 hrHPV types. We obtained registry information on socioeconomic and demographic characteristics and used log-binomial regression to estimate the prevalence ratio (PR) of hrHPV in three age groups (30-39, 40-49, 50-59 years), adjusting for age and marital status. RESULTS: We included 31,124 HPV unvaccinated women. In all age groups, the age-adjusted hrHPV prevalence was higher in women with basic versus higher education (e.g. age 30-39 11.9% vs. 9.5%; PRage-adjusted=1.24; 95% confidence interval (CI) 1.02-1.50); women who were unemployed vs. employed (e.g. age 30-39 11.6% vs. 10.4%; PRage-adjusted=1.11; 95% CI 0.95-1.28); and in women with highest vs. lowest income (e.g. age 30-39 11.6% vs. 9.5%, PRage-adjusted=1.18, 95% CI 0.98-1.44). In models adjusted for marital status, these associations largely disappeared. CONCLUSIONS: We found slightly higher hrHPV prevalences in women with basic education, low income and unemployment. The differences largely disappeared when taking into account marital status as a potential proxy for sexual behaviour. Our findings support a need for targeted information on safe sexual practices and promoting socioeconomic equality in HPV vaccination and cervical cancer screening participation.