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The phrase "almost every fifth" is correct and usable in written English.
It can be used to describe a frequency or occurrence that happens nearly every fifth instance in a series.
Example: "In the survey, almost every fifth participant reported feeling satisfied with the service."
Alternatives: "nearly every fifth" or "approximately every fifth".
Exact(6)
Interestingly almost every fifth pathologist had a positive tuberculin test during his/her career in pathology.
Almost every fifth woman (18%) in our study reported physical violence during the pregnancy.
A comprehensive study in the United States showed that almost every fifth medication dose reaching the patient is incorrect [ 8].
Nevertheless, it is noteworthy that almost every fifth adolescent perceive herself or himself as food hypersensitive and subsequently avoid certain food items.
Among chronic LBP patients (n = 1309), almost every fifth had LLD of more than 9 mm compared to only four of 50 voluntary controls who had no history of LBP [ 4].
An 83% accuracy level indicates almost every fifth assessment is erroneous, which may have an impact on the safety aspect of the assessment, i.e. drivers who are unfit to drive continue driving because their problems with visual attention was not adequately assessed.
Similar(54)
Last year, almost every third new wind turbine went up offshore.
Co-occurrence of low reading and mathematical abilities (LRLM) appears in almost every second child with learning difficulties.
LinkedIn has more than 37 million members and says it is adding a new one almost every second.
Travis Hamonic was penalized for tripping Richards with 2 minutes 4 seconds left in overtime, and the Rangers needed almost every second to score on the power play.
To complicate matters, the house needed extensive renovations, and he's spent almost every second that he hasn't been at work over the last four years doing construction.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com