Uptake of cervical cancer screening services among female caregivers of cancer patients and associated factors at the Uganda Cancer Institute

Abstract

ABSTRACT Background: Cervical cancer is the second most common cancer among women worldwide and the leading cause of cancer death among women in developing countries. The low cervical cancer screening uptake in Uganda is responsible for majority of women diagnosed with late-stage disease at Uganda Cancer Institute (UCI) that is difficult to treat. Unfortunately, the available screening services are not optimally utilized even by caregivers who can access these services free of charge at UCI while taking care of patients. Objective: The aim was to assess uptake of cervical cancer screening services among female caregivers of cancer patients at Uganda cancer institute and to determine factors associated with uptake of cervical cancer screening services among female caregivers at UCI. Methodology: This was a mixed method study that employed quantitative and qualitative methods to collect data among 220 cancer patient caregivers and five key informants .Interviewer administered questionnaire was used collect information from female caregivers. Uptake of cervical cancer screening was self-reported and a percentage of those screened was presented. Quantitative data was analysed at Univariate, bivariate and multivariable levels using STATA software. Prevalence ratio was the measure of association at 95% confidence interval. Qualitative data was transcribed verbatim, coded, and emerging sub themes and themes identified. Results Only 51/220 (23.2%) of the female caregivers had been screened for cervical cancer at UCI. Uptake of cervical cancer screening among female caregivers was associated with attainment of tertiary education (APR 3.49, 95% CI (1.47 - 8.28)), general knowledge about cervical cancer (APR 1.58, 95% CI (1.03 - 2.42)), and being knowledge about cervical cancer risk factors (APR 2, 95% CI (1.03 - 3.88)). Uptake of cervical cancer screening was also associated with being a caregiver on pediatrics OPD unit (APR 6.34, 95% CI (1.37 - 29.34)), being a caregiver to patients with breast cancer (APR 4.50, 95% CI (1.45 - 13.99)), being influenced by friends (APR 3.23, 95% CI (1.13 - 9.23)) and believing that the disease is curable (APR 3.64, 95% CI (1.54 - 8.60)). Institutional factors affecting uptake of cervical cancer screening services at UCI included limited human resources, limited funding, lack of awareness and limited supplies. Conclusion: The uptake of cervical cancer screening was low. It was associated with education level attained and general knowledge on cervical cancer. Limited funding, lack of awareness, inadequate human resources and limited supplies at UCI were responsible for low uptake. Therefore, to improve uptake of cervical cancer screening, efforts should be focused on sensitization of female caregivers, increased funding and human resources.