Factors associated with utilization of cervical cancer screening services at the Uganda Cancer Institute

Abstract

The major objective of the study was to examine factors associated with cervical cancer screening utilization at the Uganda Cancer Institute. The facility based cross sectional study involved 278 women aged 15-75 years who came to screen for cervical cancer between the months of March and May 2017 identified using a multistage sampling technique. Quantitative data was collected using a structured questionnaire, entered in Epi data version 3.02 and analyzed in Stata version 14.2. Chi-square test was used for bivariate analysis while binary logistic regression was used for multivariate analysis at a 𝑝 < 0.05 statistical significance level. Of the 278 women interviewed with a mean age of 38 years, majority (67.8%) of them had ever screened for Cacx before. The predictors of utilization of cervical cancer screening were education level, income status, referral status (recommendation to screen) and knowledge on cervical cancer. The chances of screening for cervical cancer increased for women who had tertiary education (OR=1.3; 95%CI 0.13 - 0.89, p=0.029) compared to those with primary or no education. The odds for women to screen increased for women with middle income (OR=1.4; 95%CI 0.12-1.13, p=0.050) compared to those with low income. Also, the chances to screen for cervical cancer increased for women recommended to screen by health workers (OR=6.1 95%CI 1.87 - 19.57, p=0.003) compared to those recommended by friends. The odds to screen increased also for Women knowledgeable of how cervical cancer is spread (OR=1.4 95%CI 0.21 – 0.93, P=0.032) and the stage at which it can be cured (OR=1.3 95%CI 1.62 – 9.38, P=0.030) compared to those without such knowledge. The study recommended the following to increase uptake of cervical cancer screening services: The government should work with ministry of Health to tackle geographical redistribution of cervical cancer resources, train more health workers in carrying out screening, integration of cervical cancer related services into other already existing women specific health services and mass campaigns on cervical cancer awareness. The government should also work with ministry of Education and Sports to integrate cervical cancer knowledge into the education curriculum. Then work with employment institutions to improve medical insurance plans especially for women which will also help to increase cervical cancer awareness and access to cervical cancer related services like screening and institute an annual screening test requirement met by employers. And boost women’s income by creating more women income generating projects.