Young women with (pre)malignant cervical disease in northern Netherlands: what characterises them – A population-based cohort study

Background Little is known on (pre)malignant cervical disease in women below the age of population-based screening (PBS). The aim of this study was to evaluate the occurrence of (pre)malignant cervical disease and related sociodemographic characteristics in women who are tested and/or referred by the GP before reaching the eligible age (30 years) for participation in the first round of PBS for cervical cancer in the northern Netherlands. Methods A linkage was performed between the Lifelines cohort ( N = 88439 women) and the Dutch nationwide pathology databank (Palga). Data on cervical test records and sociodemographics such as socio-economic status and smoking status were retrieved and analysed. Results A cervical test record before the first round of PBS was reported for 6301 women. Cervical intra-epithelial neoplasia grade 2 or higher (CIN2+) was diagnosed in 198 (3.1%) women. CIN2 + was associated with low educational level (adjusted odds ratio (aOR) 1.7, 95% confidence interval (CI) 1.1–2.4), ex-smoking (aOR 1.8, 95%CI 1.2–2.9) and current smoking (aOR 2.7, 95%CI 1.9–3.8). Conclusions Within women tested and/or referred by the GP before the eligible age for the Dutch cervical cancer PBS, 3.1% was diagnosed with CIN2+. Higher odds of CIN2 + for women with a low educational level and women who (used to) smoke should be taken along in clinical decision making towards testing and referral.