Determinants of cervical cancer screening disparities in Addis Ababa, Ethiopia
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Date
2019-09
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Addis Ababa University
Abstract
Background: - Cervical cancer is the fourth most common cancer in women
worldwide and the leading cause of cancer deaths in developing countries. Cervical
cancer belongs to the group of cancers that are preventable & treatable by
vaccination of HPV and by early diagnoses and screening. However, most patients,
80% of patients, in developing countries like Ethiopia, screened late with advanced
stage disease in which treatment may involve multiple modalities that is associated
with low participation in cervical cancer screening services.
Objective:- This study was aimed to assess the determinants of cervical cancer
screening disparities among women in Addis Ababa, Ethiopia.
Methods: Institutional based case control study was conducted. Controls were
women who have received screening services during the last 3-5 years and cases
were randomly selected women coming for other services but not ever screened
and aware of the screening service. Accordingly, 294 women were enrolled. Data
was collected by using structured questionnaire through interviewing. Bivariate
and multivariable logistic regression analysis was performed to assess the
association between each explanatory variables and screening disparity.
Results: The study shows respondents having higher sexual autonomy were 3.128
times more likely to have better practice on CC screening than those having lower
sexual autonomy [(AOR=3.128, 95% C.I:(1.730, 5.658)]. Women who were
referred from other health facility 67.5 % more practice to be screened CC than
those not referred from other health facility [(AOR=0.325, 95% C.I: (0.147,
0.720)]. In addition to this, women who have 1-4 children 2.844 times more likely
to have a better practice on CC screening than those having no child [(AOR=2.844,
95% C.I: (1.344, 6.014)].
Conclusion: This study revealed women’s own sexual autonomy, exposure to
referral health system and giving more birth contribute CC screening disparities.
Thus, incorporating these factors align with CC service into local health policy
efforts will enable better targeted interventions in Addis Ababa and, could also
provide focus on issues of sexual autonomy which is linked to gender
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Keywords
Cervical cancer, screening disparity, determinants