Disparities in participation in the Finnish cervical cancer screening programme: The role of birth country, education level and age

ObjectiveTo examine participation in organised cervical cancer screening in Finland by age, country of birth, education and area of residence.MethodsThis population-based register study included all women aged 25-69 invited to organised cervical screening in Finland during 2019-2023. We linked screening registry data with demographic and educational data from national registers. Country of birth was classified using the UN M49 system and grouped into six regions. Participation was described as percentages and analysed using log-linked binomial regression and adjusted for age, education, and area of residence.ResultsAmong 1,395,084 invitees, 71.5% attended screening. Participation varied substantially by region of birth, ranging from 73.1% among Finnish-born women to 45.8% among women born in Africa. Participation increased with age and was lowest among women aged 25-29. A clear educational gradient was also observed, ranging from 50.9% among women with primary education to 77.6% among those with tertiary education. After adjustment, most risk ratios shifted toward unity, but key differences persisted with all other regions of birth having lower relative participation compared to Finland. Women born in Africa had markedly lower participation than Finnish-born women (adjusted RR 0.74, 95% CI 0.73-0.76), while adjusted RR for women born elsewhere in Europe was 0.91 (95% CI 0.90-0.91).ConclusionsParticipation in Finland's organised screening programme is high overall but remains unequal by origin, education and age. Universal invitations reduce but do not eliminate disparities, highlighting the need for culturally tailored strategies to improve equity.