Sociodemographic and lifestyle determinants of non-attendance for cervical cancer screening in Lithuania, 2006-2014.

OBJECTIVES: In 2004, Lithuania started the Nationwide Cervical Cancer Screening Programme. The aim of the study was to estimate the trend in the uptake of cervical cancer (CC) screening in Lithuania during 2006-2014 and to identify sociodemographic and lifestyle factors associated with non-attendance for screening. STUDY DESIGN: Cross-sectional studies. METHODS: The data of 4248 women aged 25-60 years who participated in population-based cross-sectional surveys of Lithuanian Health Behaviour Monitoring were analysed. The postal surveys of independent random samples were conducted every second year. Participation in screening was determined by asking women whether they have had a Pap smear test within the last 3 years. Associations of non-attendance with sociodemographic characteristics and lifestyle factors were assessed by multivariate logistic regression analysis. RESULTS: The proportion of women who reported taking a test for CC within 3 years was continuously increasing from 60.0% in 2006 to 74.2% in 2014. The likelihood of not being screened was lower among older as compared to younger women (odds ratio=0.70; 95% confidence interval = 0.61-0.82). Non-attendance was associated with lower education, being single, having rare contacts with a doctor, low physical activity, and obesity. In addition, older women who smoked and consumed alcohol at least once a week were more likely to have never been screened. CONCLUSIONS: Established social and behavioural determinants of non-attendance for CC screening should be used for optimising CC prevention in Lithuania. The implementation of organised screening programme using innovative screening methods might increase attendance and reduce inequalities.

Physical activity, but not dietary intake, attenuates the effect of the FTO rs9939609 polymorphism on obesity and metabolic syndrome in Lithuanian adult population.

OBJECTIVES: This study aimed to examine the associations between the fat mass and obesity associated (FTO) gene rs9939609 variant with obesity and metabolic syndrome and interactions between FTO alleles, dietary intake and physical activity in Lithuanian adult population. STUDY DESIGN: Cross-sectional study. METHODS: A health survey was carried out in randomly selected municipalities of Lithuania. The random sample was obtained from the lists of 25-64 year-old inhabitants. The data from 1020 individuals were analyzed. The single-nucleotide polymorphism, rs9939609, in the FTO gene was assessed using a real-time polymerase chain reaction. 24-hour recall was used for evaluation of dietary habits. Information on physical activity at work, traveling to and from work and at leisure time was gathered by a standard questionnaire. RESULTS: The carriers of the AA genotype had the highest mean values of body mass index (BMI) and waist circumference (WC). They had 1.72 time higher odds of obesity (P = 0.009) and 1.67 time higher odds of increased WC (P = 0.013) than those with the TT genotype. Carriers of the T allele had lower prevalence of metabolic syndrome compared to carriers of the AA genotype (33.8% and 42.5% respectively; P = 0.018). No interaction between the rs9939609 variant and energy or dietary intakes on weight status was found. Significant effect of the interactions 'genotype×age' and 'genotype×physical activity' on BMI was demonstrated. The FTO rs9939609 polymorphism was associated with anthropometric parameters and metabolic syndrome in the younger age group (25-44 years) and in individuals having low level of physical activity. CONCLUSIONS: Age and physical activity modulated the effect of the FTO polymorphism on weight status and metabolic syndrome in Lithuanian adult population.

The prevalence and trends of overweight and obesity among Lithuanian adults, 1994-2012.

OBJECTIVES: The aim of this study was to assess trends in body mass index (BMI) and in the prevalence of overweight and obesity among Lithuanian adults between 1994 and 2012. STUDY DESIGN: The data were obtained from ten biennial cross-sectional surveys of Lithuanian Health Behaviour Monitoring. For every survey, a nationally representative random sample aged 20-64 was drawn from the National Population Register. Response rates ranged from 51% to 74%. In total, 7968 men and 10,695 women reported their weight and height. METHODS: All surveys used the same methodology and questionnaires, which were sent by mail. Self-reported weight and height were used to calculate body mass index (BMI). Overweight was defined as BMI ≥ 25 kg/m(2) and obesity--as BMI ≥ 30 kg/m(2). RESULTS: The most prominent increase in mean BMI was observed in the oldest age group (55-64 years) of men. A decrease in mean BMI occurred in the youngest age groups (20-34 and 35-44 years) of women. The proportion of overweight men increased from 47.0% to 62.5%, and the proportion of obese men--from 10.6% to 19.0%. In women, the prevalence of obesity was similar in the first and in the last survey (19.0% and 20.5% respectively). CONCLUSIONS: Over the study period, the difference in the prevalence of overweight and obesity increased between the age groups, because of age-related trends. Our data emphasize the need for a national strategy for obesity prevention and control targeting the whole population, particularly men and older women.

Explaining educational differences in leisure-time physical activity in Europe: the contribution of work-related factors.

Although educational differences in leisure-time physical activity (LTPA) exist across Europe, the independent effect of educational level on leisure-time physical activity has rarely been explored. This study examines the relative contribution of occupational class, employment status, and educational level to LTPA across 12 European countries. The data were obtained from 12 European health surveys conducted at the turn of the century and identified in the EUROTHINE project. All information was self-reported. Logistic regression was applied and relative inequality index (RII) was calculated. Analyses were limited to those in the prime working-age (age 30-59; total N=137,646) men and women. In all 12 European countries, LTPA was more common in the high-educated than in the low-educated. The association between education and LTPA remained mostly unchanged after adjusting for marital status, urbanization, and self-rated health. After further adjusting for occupational class and employment status, the educational differences in LTPA were only slightly attenuated. An inverse association was found between educational level and LTPA across almost all 12 European countries. Occupational class and employment status had only a modest effect on educational differences in LTPA in most of the examined countries, suggesting that education remains an important predictor of LTPA.

Effect of nationwide tobacco control policies on smoking cessation in high and low educated groups in 18 European countries.

BACKGROUND: Recently a scale was introduced to quantify the implementation of tobacco control policies at country level. Our study used this scale to examine the potential impact of these policies on quit ratios in European countries. Special attention was given to smoking cessation among lower educational groups. METHODS: Cross-sectional data were derived from national health surveys from 18 European countries. In the analyses we distinguished between country, sex, two age groups (25-39 and 40-59 years) and educational level. Age-standardised quit ratios were calculated as total former-smokers divided by total ever-smokers. In regression analyses we explored the correlation between national quit ratios and the national score on the Tobacco Control Scale (TCS). RESULTS: Quit ratios were especially high (>45%) in Sweden, England, The Netherlands, Belgium and France and relatively low (<30%) in Lithuania and Latvia. Higher educated smokers were more likely to have quit smoking than lower educated smokers in all age-sex groups in all countries. National score on the tobacco control scale was positively associated with quit ratios in all age-sex groups. The association of quit ratios with score on TCS did not show consistent differences between high and low education. Of all tobacco control policies of which the TCS is constructed, price policies showed the strongest association with quit ratios, followed by an advertising ban. CONCLUSION: Countries with more developed tobacco control policies have higher quit ratios than countries with less developed tobacco control policies. High and low educated smokers benefit about equally from the nationwide tobacco control policies.

Smoking and passive smoking in Estonia, Lithuania and Finland. Identifying target groups of tobacco policy.

BACKGROUND: The aim of this study was to identify population groups which are the most crucial as targets for anti-tobacco action. METHODS: A comparison was made of the prevalence and patterns of smoking and passive smoking in Estonia, Finland and Lithuania. RESULTS: Total exposure to smoking, both one's own and passive smoking, was more common in two Baltic countries than in Finland. In these Baltic countries passive smoking was notably common among women. In all countries the exposure was more prevalent among the younger and less educated, but no difference emerged between urban and rural areas. CONCLUSIONS: The following target groups were identified as priorities for anti-tobacco actions: i) men of all ages in Estonia and Lithuania to stop their already established tobacco use, ii) young women in all three countries to prevent their starting a career of tobacco use and iii) young and less educated women in Estonia and Lithuania to prevent passive smoking, i.e. their exposure to environmental tobacco smoke.

Disparities in vegetable and fruit consumption: European cases from the north to the south.

OBJECTIVE: To present disparities in consumption of vegetables and fruits in Europe and to discuss how educational level, region and level of consumption influence the variation. DESIGN: A review of selected studies from 1985 to 1997. SETTING/SUBJECTS: 33 studies (13 dietary surveys, nine household budget surveys and 11 health behaviour surveys) representing 15 European countries were selected based on criteria developed as part of the study. Association between educational level and consumption of vegetables and fruits was registered for each study and common conclusions were identified. RESULTS: In the majority of the studies, with the exception of a few in southern and eastern Europe, consumption of vegetables and fruits was more common among those with higher education. The results suggest that in regions where consumption of vegetables and fruits is more common, the lower social classes tend to consume more of these than the higher social classes. CONCLUSIONS: The differences in the patterns of disparities in vegetable and fruit consumption between regions, as well as within populations, need to be considered when efforts to improve nutrition and health are planned.

The relationship of childhood to adult blood pressure: longitudinal study of juvenile hypertension in Lithuania.

OBJECTIVE: To assess changes in blood pressure from childhood to adulthood and the ability to predict adult blood pressure. DESIGN: Longitudinal study of a cohort of children with baseline data and a follow-up survey after 20 years. SETTING: Epidemiological survey of schoolchildren and subsequent inhabitants of Kaunas, a town in Lithuania. PARTICIPANTS: The children came from 15 schools and accounted for 25% of all 12- and 13-year-old children born in 1964 in Kaunas. The first survey (n = 1082) was carried out in 1977. The same population was re-examined in 1997 (n = 505). Data from 217 men and 288 women, who participated in both the first and the most recent surveys, is presented. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure at the age of 32-33 years. RESULTS: In the 20 years between the two surveys blood pressure increased more in men than in women. Statistically significant correlation between childhood and adult blood pressure levels was estimated (for systolic blood pressure r=0.40 in men and r=0.24 in women; for diastolic blood pressure r=0.14 in men and r=0.34 in women). Stepwise regression analysis of the data showed that the best predictors of adult blood pressure were the initial childhood blood pressure levels and change in BMI during the 20-year period for both men and women. Other factors were less predictive. CONCLUSIONS: Childhood blood pressure is related to adult levels and, together with changes in body mass index, is a significant predictor of adult blood pressure.