Assessment of the Uptake and Determinants of Cervical Cancer Screening Among Women in Slum Areas of Addis Ababa, Ethiopia
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Date
2025-05-24
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Addis Ababa University
Abstract
Background:
Cervical cancer is the fourth most common cancer in women and the fourth leading cause of cancer deaths in women. Cervical cancer is preventable through screening, and vaccination. Despite public health efforts, screening remains low among women in slum areas where socioeconomic vulnerabilities like limited education and poor health seeking behavior further limit the uptake.
Objective:
The aim of the study was to assess the uptake and determinant of cervical cancer screening in selected slum areas of Addis Ababa, Ethiopia.
Methods:
Community-based cross-sectional study was conducted among 576 women who live in a selected slum area of Addis Ababa from February to May 2025, using a multistage sampling technique. The study used a mixed method approach. Quantitative data was collected using structured questionnaires, while qualitative data was collected using focus group discussions and in-depth interviews. Descriptive analysis, binary logistic regression and Multivariable logistic regression were applied to summarize and show association of the quantitative data. Qualitative data was coded using MAXQDA software and analyzed through thematic analysis.
Result:
The study showed the prevalence of cervical cancer screening among women in slum area of Addis Ababa was 25%. Women aged 40 and above had 2.5 times higher odds of screening(AOR = 2.56; 95% CI: 1.43 - 4.58), women with higher education had 4.4 times higher odds of screening (AOR = 4.42; 95% CI: 1.96 - 9.96) and those with good knowledge had 5.37 times higher odds of screening (AOR = 5.37; 95% CI: 3.20 - 8.98), while those practicing health-seeking behaviors were more likely to get screening (AOR = 2.09; 95% CI: 1.25 - 3.48). These factors significantly influenced cervical cancer screening uptake in the study population. Qualitative findings showed that low awareness, cultural beliefs, and fear of judgment hindered cervical cancer screening uptake. Discomfort with male healthcare providers and being judged by their community was a key barrier.
Conclusion and Recommendation:
Cervical cancer screening uptake in the study area falls significantly short of the global coverage targets set for elimination efforts, indicating a need for substantial intervention. The study found particularly low screening rates among younger women, those with no formal education and with poor health-seeking behavior and limited knowledge of cervical cancer and its screening. Targeted education initiatives and integrated awareness programs are essential to increase screening uptake among vulnerable groups.
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Keywords
Cervical Cancer, Screening, Slum Area, Vulnerability, Addis Ababa