Women's lifestyle and health - research on lifestyle, viruses and cancer
Purpose
We look at how different lifestyle habits (such as smoking, contraceptive and sexual habits) can affect the risk of getting cervical cancer and other HPV-related diseases and to what extent the introduction of the HPV vaccine may have affected women's lifestyle and health.
Knowledge from this study is used to prevent cervical cancer more effectively and to improve health services for women.
Data basis
This is a study of the female population in Norway who were aged 18-45 years when they participated in a questionnaire survey. In 2004-2005 and in 2011-2012, the women were sent a questionnaire that dealt with sexual behaviour, lifestyle habits, medical history and attitudes to cervical cancer screening. The sample consisted of a total of 52,000 women, of whom 59% responded to the questionnaire. The women were randomly drawn from the National Registry.
The same survey also took place in Sweden, Iceland and Denmark.
For those who participated in the study
In 2017, the Regional Committees for Medical and Health Research Ethics (REK) approved that data from the survey can be linked to additional Norwegian registries, and the study can currently be linked to the Norwegian Prescription Database, the Norwegian Patient Registry, the Medical Birth Registry, Statistics Norway, the National Immunisation Registry, the National Registry and the Cancer Registry of Norway. Furthermore, the study period has been extended to 31.12.2025. Similar changes have been made for the studies in Sweden, Denmark and Iceland, so that we can still combine data from several countries. The changes have been made in order to investigate possibilities for more personalised screening against cervical cancer.
Did you submit a questionnaire and have questions about the study, or wonder how privacy is taken care of? Find answers below:
Why was I invited?
26,000 Norwegian women aged 18 to 45 were invited to participate in the study on lifestyle and cervical cancer prevention. Your name and address were randomly drawn from the Population Register. The 18-45 age group was chosen because it is frequently exposed to HPV infections and precursors to cervical cancer. A similar study is being carried out in Denmark and Sweden.
What is the purpose of the study?
We will investigate how different lifestyle habits can affect the risk of getting cervical cancer and other HPV-related diseases. We will also investigate the extent to which the introduction of the HPV vaccine may have affected women's lifestyle and health. The results will be compared with a similar study carried out in 2004-2005. The knowledge can be used to prevent cervical cancer and other HPV-related diseases more effectively and to improve health care for women.
Why was it important that I answered?
Women have different experiences and attitudes towards lifestyle and health. The more people who participated in the study, the more certain we can be that we are getting a correct picture of lifestyle and health among Norwegian women aged 18 to 45. In order for the study's results to reflect reality in the population, it was therefore important that as many people as possible participated. We will use the results to research the causes and prevention of cervical cancer and other HPV-related diseases.
Why did you ask about my sexual habits?
HPV infection is most often harmless and without symptoms, but in some it causes cell changes that over several years can lead to cervical cancer. HPV can also cause genital warts. Since HPV infections that can cause cancer or genital warts are sexually transmitted, we need information about sexual habits to gain knowledge about what influences the risk of developing HPV-related diseases.
Why is such a study being carried out in Scandinavia?
The Scandinavian countries have very good health records. The health registers provide a good overview of the prevention and occurrence of disease in the population, and also provide the opportunity to follow individual trends over time. The high quality of our health registers is important for this study. The Scandinavian countries were also relatively early adopters of the HPV vaccine. There are also certain differences between the Scandinavian countries, both in HPV-related disease incidence and in the use of the HPV vaccine. Collectively, this provides a very good basis for research into the causes of and prevention of HPV-related diseases.
Who is behind the study?
The study is carried out by the Cancer Register in collaboration with the Karolinska Institute in Sweden and the Danish Cancer Society. The vaccine manufacturer MSD/Merck is financing the study. The survey has been approved by the Regional Committee for Medical and Health Research Ethics. Oslo University Hospital's managing director is responsible for data processing.
How does funding from the pharmaceutical industry affect research?
The Norwegian Cancer Registry's research must maintain a high ethical standard. Even if the research results prove not to benefit the pharmaceutical industry, they must be made public and published. The study has been approved by the Regional Committee for Medical and Healthcare Research Ethics, a body that assesses all ethical aspects of research projects before they can be implemented.
How do you safeguard privacy?
All information will be treated strictly confidentially and will only be used in statistical tables where it will be impossible to identify participants. In our data files, answers from participants will only be linked to an anonymised study number, and all recognizable information about participants (name, address etc.) will be deleted. The vast majority of people who work with the data will only have access to anonymised data, and everyone who works with the study also has a duty of confidentiality. Only a few authorized, confidential data processors at the Cancer Registry have access to the code that can link the participants' study number to personal data.
What happened after I answered the questionnaire?
Answering the questionnaire does not involve any additional work for you. The results of the study will be used for research to be published in scientific articles and reports.
Can I withdraw from the study?
Yes, you can withdraw from the study at any time and without giving a reason without this having consequences for you. If you choose to participate, you can later withdraw by contacting us in writing. Information about you will then be deleted (this does not apply if results are already included in analyzes or have been published). You have full access to the information recorded about you in the study and you have the right to correct any errors in the information we have recorded.
Status
The questionnaire data are now in the process of being linked to data from the Nordic cancer registries. The purpose is to analyze behavioral risk factors for cancer.
A number of articles have already been published. See below.
Selected publications
Hansen BT, Kjaer SK, Arnheim-Dahlstrøm L, Liaw KL, Jensen KE, Thomsen LT, Munk C, Nygård M (2014). Human papillomavirus (HPV) vaccination and subsequent sexual behaviour: Evidence from a large survey of Nordic women. Vaccine. 2014 Jul 18. DOI 10.1016
Age at first intercourse, number of partners and sexually transmitted infection prevalence among Danish, Norwegian and Swedish women: estimates and trends from nationally representative cross-sectional surveys of more than 100 000 women
Acta Obstet Gynecol Scand
doi 10.1111/aogs.13732, PubMed 31529491
Thomsen LT, Nygård M, Stensen S, Terning Hansen B, Arnheim Dahlström L, Liaw KL, Munk C, Kjaer SK (2017)
Awareness of human papillomavirus after introduction of HPV vaccination: a large population-based survey of Scandinavian women
Eur J Cancer Prev, 26 (2), 170-178
PubMed 27010329
Klungsøyr Ø, Nygård M, Skare G, Eriksen T, Nygård JF (2009). Validity of self-reported Pap smear history in Norwegian women.
J Med Screen 2009, June 29
Kjær SK et al. The burden of genital warts: a study of nearly 70,000 women from the general female population in the 4 Nordic countries.
J Infect Dis 2007 Nov 15
