Cervical Cancer Screening in Uganda: Determinants of Past Screening and Post-Education Uptake; A Cross-Sectional Survey.

Abstract

IntroductionCervical cancer (CC) is the leading cause of cancer-related deaths among women in Uganda, largely due to late diagnosis. CC screening (CCS) is key to preventing these deaths. Awareness of past CCS, its determinants, and uptake of CCS after receiving information is crucial to informing prevention programming.MethodsA two-phase community based cross-sectional survey was conducted among 600 randomly selected women aged 25-65 years, from two Ugandan districts (Mukono and Wakiso). Participants completed a baseline questionnaire that assessed their knowledge, attitudes, and past practices related to CCS. Information on cervical cancer and screening was provided during and after the survey to encourage uptake, which was assessed three months later. Logistic regression identified factors associated with past CCS and follow-up uptake after information giving.ResultsFew women [5.3%, (32/600)] were aware that Human Papillomavirus (HPV) infection causes CC. Past CCS was low [22.3%, (134/600)], associated with the age group 36-65 years (AOR= 1.9, 95% CI 1.2 - 3.2), owning a mobile telephone (AOR = 2.3, 95% CI 1.4 - 3.9), residing in a household headed by someone with tertiary or higher education (AOR=2.6, 95% CI 1.3 - 5.0), self-reported HIV infection (AOR=10.5, 95% CI 5.2 - 21.3), awareness of the location of CCS services (AOR=3.2, 95% CI 1.3 - 7.8), and awareness that accessing the CCS location was not expensive (AOR=2.3, 95% CI 1.3 - 4.0).The uptake of CCS following information provision was 40.3%, (236/585), associated with employment (AOR=2.7, 95% CI 1.2 - 5.8), moderate-high income (AOR=1.6, 95% CI 1.0 - 2.6), and prior receipt of CCS services (AOR 6.7, 95% CI 4.0 -11.2).ConclusionCCS remains low but is higher among women with better socioeconomic status, awareness of services, and HIV infection. Targeted strategies addressing awareness and motivating women to get screened can boost screening uptake.