Factors associated with awareness and uptake of breast and cervical cancer screening among Nepalese women: Evidence from Nepal demographic and health survey 2022

Objective To determine the factors associated with awareness and uptake of breast cancer screening (BCS) and cervical cancer screening (CCS) among Nepalese women aged 15-49 years. Methods We analyzed data from nationally representative Nepal demographic health survey 2022. We used weighted analysis to account for complex survey design of the survey. We presented categorical variables with frequency, percent (%) and 95% CI around percent. We used univariate and multivariable logistic regression to determine factors associated with awareness and uptake of BCS and CCS. The results of regression analysis were presented with crude odds ratio (COR) and adjusted odds ratio (AOR) and their 95% CI. Results The awareness and uptake of BCS among Nepalese women were 48.9% and 4.4% respectively whereas the awareness and uptake of CCS were 29.9% and 6.4% respectively among Nepalese women. The awareness of BCS and CCS were 1.10 and 1.22 times respectively among women with media exposure and 1.58 and 1.24 times among women with health insurance coverage. Compared to the poorest, the richest and richer have higher odds of being aware of BCS and CCS and have higher odds of BCS and CCS uptake. The uptake of CCS was 5.64 times higher among women who have heard about CCS and women who had heard about BCS had 7 times higher odds of BCS uptake. Conclusion Though awareness is relatively good, the uptake of BCS and CCS screening was very poor in Nepalese women. Provinces, ethnicity, age, education, wealth, marital status, employment, media exposure and health insurance coverage were identified as key factors associated with the awareness and uptake of BCS and CCS. These findings highlight the importance of considering socio-demographic factors in implementing effective cancer screening programs and targeting specific populations for increased awareness and uptake of screenings.