Uptake of cervical cancer screening and its predictors among women of reproductive age in Gomma district, South West Ethiopia: a community-based cross-sectional study

Association between multiple dimensions of access to care and cervical cancer screening among Kenyan women: a cross-sectional analysis of the Demographic Health Survey

BACKGROUND

Cervical cancer remains the second most common cause of death in women and poses a growing public health challenge. It is urgent to increase cervical cancer screening rates in Kenya as per the 2018 Kenya National Cancer Screening Guidelines. Addressing access to care may serve as a target to achieve this goal; however, how individual dimensions of access to care are associated with the utilization of cervical cancer screening services in low- and middle-income countries, including Kenya, remains unclear. This study aimed to examine how different aspects of access to care (affordability, availability, geographical access, and social influence) were associated with cervical cancer screening among Kenyan women of reproductive age.

METHODS

This cross-sectional study used data from the 2014 Kenya Demographic and Health Survey and the 2010 Kenya Service Provision Assessment. The final sample included 5,563 women aged 25-49 years. Logistic regression models were used to examine the association between different aspects of access to care and the uptake of cervical cancer screening.

RESULTS

Factors such as being in the poorest wealth quintile, lacking health insurance, having difficulty obtaining funds for treatment (affordability), limited availability of screening services at nearby facilities (availability), living in rural areas (geographical access), and having healthcare decisions made solely by husbands/partners or others (social influence) were associated with a decreased likelihood of the uptake of cervical cancer screening.

CONCLUSIONS

Increasing health insurance coverage, enhancing the availability of screening services at health facilities, expanding mobile screening health facilities in rural areas, and empowering women to make their own healthcare decisions are crucial steps for increasing cervical cancer screening uptake in Kenya.

Factors Influencing Cervical Cancer Screening Uptake among Reproductive-Aged Filipino Women: Findings from the 2022 Philippines National Demographic and Health Survey

Background

Cervical cancer (CC) is the fourth leading cause of death among cancer cases and women intimate partner violence (IPV) survivors are more likely to experience CC-related mortality. This study aims to evaluate the factors influencing CC screening uptake among reproductive-aged women, especially among IPV survivors in the Philippines.

Method

We used the 2022 Philippines' National Demographic and Health Survey. The outcome variable was undergoing CC screening. The independent variables were different types of IPV, sociodemographic characteristics (age groups, place of residency, education level, wealth quintile, marital status, religion, employment), and other important variables (number of sexual partners, number of children, and access to health care). Descriptive statistics and multivariable logistic regression analyses were performed to examine influencing factors of CC screening.

Method

The results revealed that approximately 10% (n = 1,648) of the women who participated in the survey had screened for CC. The results showed that women who experienced at least one type of IPV (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI] = 1.08-1.62), aged 45-49 years (aOR = 6.42, 95% CI = 2.60-15.54), higher education (aOR = 14.26, 95% CI = 3.28-61.99), wealthier (aOR = 3.46, 95% CI = 2.54-4.72), having current employment (aOR = 1.30, 95% CI = 1.08-1.57), and having more than five lifetime sexual partners (aOR = 3.16, 95% CI =1.00-9.97), were more likely to undergo CC screening than their counterparts.

Conclusion

Future CC screening initiatives should prioritize women with lower educational and socioeconomic backgrounds to effectively bridge the gaps in health disparities.

Implementation of cervical cancer prevention and screening across five tertiary hospitals in Nepal and its policy implications: A mixed-methods study

In Nepal, cervical cancer is the most common cancer among women despite the existing policies. This study intends to assess the implementation of cervical cancer prevention and screening through service utilization by women, knowledge and attitude among health professionals, and the perceptions of stakeholders in Nepal. This mixed-methods study was conducted in 2022 across five tertiary hospitals in Kathmandu, Nepal. The quantitative study comprised the health professionals and women attending gynecology outpatient clinics from the selected hospitals. The qualitative study comprised stakeholders including service providers and experts on cervical cancer from selected hospitals, civil societies, and the Ministry of Health and Population. The utilization of screening through pap smear among 657 women across five hospitals was 22.2% and HPV vaccination was 1.5%. The utilization of cervical cancer screening was associated with older age [adjusted odds ratio (AOR) = 1.09, CI: 1.07, 8.19], married (AOR = 3.024, CI: 1.12, 8.19), higher education (AOR = 3.024, CI:1.12, 8.42), oral contraceptives use (AOR = 2.49, CI: 1.36, 4.39), and ever heard of cervical cancer screening (AOR = 13.28, CI: 6.85, 25.73). Among 254 health professionals, the knowledge score was positively associated with them ever having a training [Standardized Beta (β) = 0.20, CI: 0.44, 2.43)] and having outreach activities in their hospital (β = 0.19 CI: 0.89, 9.53) regarding cervical cancer screening. The female as compared to male health professionals (β = 0.16, CI: 0.41, 8.16, P = 0.03) and having a cervical cancer screening guideline as compared to none (β = 0.19 CI: 0.89, 9.53, P = 0.026) were more likely to have a better attitude for screening. The qualitative findings among 23 stakeholders reflected implementation challenges in policy, supply, service delivery, providers, and community. This study showed low utilization of prevention and services by women and implementation gaps on cervical cancer prevention and screening services across five tertiary hospitals in Kathmandu, Nepal. The findings could help designing more focused interventions.