Cervical Cancer Screening Uptake and Associated Barriers: A Cross-Sectional Survey at Chawama Level One Hospital, Lusaka, Zambia
Abstract
Background: Cervical Cancer is globally ranked fourth cancer in women with the highest incidence and mortality in Africa. Screening for cervical cancer has proven to be effective in reducing the burden of the disease in developed countries. In Zambia, cervical cancer screening uptake has been repeatedly reported to be low. The objective of this study was to determine cancer screening uptake and associated barriers.
Methods: A cross-sectional design involving 384 antenatal and postnatal mothers at Chawama Level I Hospital in Lusaka was used. Questionnaires and Focus Group Discussions were used to collect data from mothers. Two health workers were interviewed as Key Informants. Quantitative data were collected using a questionnaire adapted from the Cervical Cancer Awareness Measure. Quantitative data was analyzed using descriptive statistics and logistic regression using SPSS version 20. Thematic and narrative analyses were used to analyze qualitative data.
Results: This study revealed that only 44.8% (n=168) of mothers were ever screened for cervical cancer and the majority of them (24.3%: n=91) did so only once. The study showed an Odds Ratio (OR) of 44.642 [95% CI: 18.151-109.796, P<0.01], OR of 4.313 for hearing about cervical [95% CI: 1.879-9.902, P=0.001], and OR of 2.457 [95% CI: 1.141-5.290, P=0.022], Barriers found to be affecting screening uptake included: fear of pain, embarrassment, not knowing service availability, lack of perceived benefits, proximity of the facility coupled with lack of transport money, and long waiting time.
Conclusions: The study found that screening uptake was low (44.8%). Barriers to screening include fear of pain, embarrassment, not knowing service availability, lack of perceived benefits, proximity of the facility coupled with lack of transport money, and long waiting time. Participants who were offered Pap smear by health workers were over 44 times more likely to be screened.
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