Determinants of cervical cancer screening utilization among women attending health facilities of Dessie town, Northeast Ethiopia

Abstract

Introduction Despite the higher burden of cervical cases, screening programs in highly affected developing countries remained low. This made the disease to be present at an advanced stage which is almost always fatal, causing enormous pain and suffering for the individual and having significant adverse effects on the welfare of their families and community. Thus, this study aimed to assess determinants of cervical cancer screening utilization among women attending health facilities in Dessie Town, Northeast Ethiopia. Methods An institution-based unmatched case–control study design was employed on 430 women (146 cases and 284 controls) at selected health facilities of Dessie town, South Wollo Zone, from July 1/2020 to August 30/2020. Cases were selected for all women screened for cervical cancer during the data collection period until the required sample size was attained and using a consecutive sampling technique, every 3 participants from women who come for services other than cervical cancer screening. were included as controls. Pretested and structured questionnaires were used to collect the data. Data were analyzed by SPSS version 25 software. Bivariable and multivariable logistics regression analysis was done. An adjusted odds ratio with 95% CI was estimated to measure the strength of the association. The level of statistical significance was declared at a p-value < 0.05. Result Age group of 35 and more [AOR = 11.52(6.09–21.77)], being a private employee [AOR = 4.67(2.41–9.03)], having symptoms of vaginal bleeding or pelvic pain or postcoital bleeding or vaginal discharge [AOR = 3.08(1.37–6.95)], being recommended by a physician for screening [[AOR = 3.07(1.45–6.49)] and positive attitude towards cervical cancer screening [AOR = 5.3(2.8–10.59)] were determinants of cervical cancer screening. Conclusion Age group of 35 and more, current occupation as a private employee, having symptoms of cervical cancer, being recommended by a physician for screening, and positive attitude towards cervical cancer screening were determinants of cervical cancer screening utilization.

Determinants of cervical cancer screening utilization among HIV-positive women, in public general hospitals of Central Zone, Tigray, Ethiopia, 2020: Case-control study

“…This study showed lower cervical cancer screening utilization among HIV-positive women in the 18–30 age group as compared to as compared to women aged 41 and above. This result is in line with previous studies donein Tigray,Ethiopia [ 19 ], Dessie Town, North East Ethiopia [ 20 ], and Addis Ababa, Ethiopia [ 21 ], which revealed that women in the 18–29 age cohort were less likely to access cervical cancer screeningas compared to women in the (40–49) age cohort. A possible explanation may be that younger womendo not have adequate exposure to informationabout cervical cancerscreening, whereas older womenmay have more exposure to health information when visiting health facilities for different services.…”

“…This study also showed that women who did not work outside the home wereless likely to utilize cervical cancer screening than women working for the government. This finding is in line with studies conducted in Addis Ababa, Ethiopia [ 17 ] and Dessie Town, North East Ethiopia [ 20 ], which showed that the probability of cervical cancer screening was higher among government employees than among those who were non-employed. A possible explanation for these results is that women who do not work outside the home may not have exposure to information about cervical cancer and its screening from different sources, such as workplaces and work colleagues [ 20 ].…”

“…A possible explanation may be that younger womendo not have adequate exposure to informationabout cervical cancerscreening, whereas older womenmay have more exposure to health information when visiting health facilities for different services. Additionally,Ethiopian health policy advises cervical cancer screening for women over the age of 30 [ 20 ], which may lead younger women to view themselves as lower risk groups forcervical cancer related morbidity and mortality.…”

“…This study also showed that HIV-positive women who had an unfavorable attitude toward cervical cancer screening hada lower likelihood ofutilizing cervical cancer screening compared toHIV-positive women with a favorable attitude toward cervical cancer screening. This finding was demonstrated by astudy done in Tigray, Ethiopia [19], Dessie Town, North East Ethiopia [20] and northern Malaysia [24]. Because action may be linked to pre-existing attitudes, a woman with an unfavourable attitude about cervical cancer screening may be less likely to utilize the cervical cancer screening.…”

Improving cervical cancer continuum of care towards elimination in Ethiopia: a scoping review

“…These were a cervical cancer screening campaign assisted by robust technology (43), health education at the coffee ceremony (44) and other settings (45), and 'single-visit approach'/ 'Addis Tesfa Project' (46). Individual and social determinants that encouraged utilization of cervical cancer screening were having symptoms of vaginal bleeding, physician recommendation (47), women having attended formal education and having good knowledge toward cervical cancer screening, a history of sexually transmitted infections (39), a favourable attitude about cervical cancer and screening (48) and higher sexual autonomy (49). Another study involving health workers also identi ed barriers such as low community and provider awareness of cervical cancer, lack of space and equipment to offer screening, and lack of support from leaders (50), social and religious in uence (51).…”