Uptake of Cervical Cancer Screening and Its Associated Factors Among Women of Reproductive Age in Kericho County

Uptake of Cervical Cancer Screening and Its Associated Factors Among Women of Reproductive Age in Kericho County | medRxiv /* */ /* */ <!-- <!-- /*! * yepnope1.5.4 * (c) WTFPL, GPLv2 */ (function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-P4HH5NV'); Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search Uptake of Cervical Cancer Screening and Its Associated Factors Among Women of Reproductive Age in Kericho County View ORCID Profile Joel Wanzala , Calvince Otieno Anino doi: https://doi.org/10.1101/2025.07.06.25330970 Joel Wanzala 1 Public Health Department, University of Kabianga , Kericho County, Kenya Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Joel Wanzala For correspondence: abbysansiojoel{at}gmail.com Calvince Otieno Anino 1 Public Health Department, University of Kabianga , Kericho County, Kenya Find this author on Google Scholar Find this author on PubMed Search for this author on this site Abstract Full Text Info/History Metrics Data/Code Preview PDF ABSTRACT Background Cervical cancer is a prevalent non-communicable and public health issue among reproductive-aged women worldwide. It is the second most common cancer among females and contributes to 12.9% of new cancer cases and 11.84% of all cancer deaths annually. Early detection and treatment can prevent and cure the disease. Screening among women has gained global attention, with 500,000 women developing cervical cancer annually, of which 85% occurs in developing countries. This study investigated prevalence and factors associated with cervical cancer screening among women aged 18–49 years in Bureti Constituency, Kericho County. Methods The study adopted an institution-based cross-sectional study design. The study used systematic random sampling technique to select 328 women aged 18–49 who attended maternal and child health clinic at Kapkatet Sub-County Hospital during study period. Data was collected using structured questionnaires, including sociodemographic, awareness and knowledge and screening uptake sections. The data was analyzed using SPSS version 20.0. Descriptive analyses were performed to all the variables. Binary logistic regression analyses were conducted to assess factors associated with cervical cancer screening. Results The study involved 328 women of reproductive age. This study found that the prevalence of cervical cancer screening was 16.2% (95% CI: 10.5-23.4). Being 34 years and above (aOR: 1.43, 95% CI: 1.11 – 2.52, p < 0.001), primary education (aOR: 3.83, 95% CI: 1.72 – 8.54, p = 0.001), self-employed (aOR: 5.98, 95% CI: 2.94 – 12.15, p < 0.001), unemployed (aOR: 8.96, 95% CI: 2.74 – 29.27, p < 0.001), and family history of cervical cancer (aOR: 2.14, 95% CI: 0.74 – 6.12, p = 0.016) significantly increased odds of screen uptake. Additionally, lack of awareness of screening, and poor knowledge on risk factors, signs and symptoms and groups at risk were less likely to screen. Conclusion Low screening uptake emphasizes need for more community-based public health initiatives to raise awareness and knowledge on cervical cancer and its screening. The findings of this study inform tailored interventions to enhance the knowledge and uptake of cervical cancer screening in Kericho County. BACKGROUND INFORMATION Cervical cancer is a prevalent non-communicable and public health issue among reproductive-aged women worldwide ( 1 ), with approximately 660,000 women developing the disease annually ( 2 , 3 ). With early detection and treatment, it is a preventable and curable disease ( 4 ). Sub-Saharan Africa has the highest regional incidence and mortality, with Eastern Africa, Southern Africa, and central Africa having the highest rates ( 5 , 6 ). Cervical cancer rates are disproportionately high in developing countries, with low Human Development Index (HDI) and poverty rates responsible for over 52% of the global variance in mortality ( 7 ). The absence of effective cervical screening has led to a rapid elevation in premature cervical cancer mortality in recent years. In Kenya, cervical cancer is one of the major causes of cancer-related deaths and the second most common cancer among females, contributing to 12.9% of new cancer cases and 11.84% of all cancer deaths annually ( 7 , 8 ). It is the leading cause of all cancer deaths in Kenya, with over 3,200 deaths in 2020 ( 2 ). Public health programs, such as cervical cancer screening of women for precancerous changes, treatment, and follow-up care at the early stages of the disease, are reported to be more significant ( 9 ). Studies by D’Augè et al. ( 9 ) and Singh et al. ( 10 ) have identified cervical cancer screening as the best approach towards achieving significant reduction in the incidence, morbidity, and mortality of cervical cancer. It’s therefore important for all women within the reproductive age bracket (15-49 years) to have cervical cancer screenings to detect any abnormal cells. As reported by Teklehaimanot et al. ( 11 ) if cervical cancer is detected early, timely treatment should be initiated to avoid the precancerous cells from developing into tumors or carcinoma. Most scholars concur that cervical cancer screening should be done via visual inspection of the cervix with lugol’s iodine (VILI), a papanicolaou (PAP) smear, and a visual inspection of the cervix with acetic acid (VIA) ( 12 ). Once screened negative, it is advised that rescreening should be done after five years ( 13 ). However, these screening processes have been reported as laborious and could potentially be a reason to shun screening ( 14 ). This is a concern given that there has been a rise in the number of new cases from 12.9% in 2018 to about 19.7% in 2020 ( 2 ). Besides, Ng’ang’a et al. ( 15 ) reported low uptake of screening and screening services of about 16% of Kenyan women within reproductive age seeking for screening services and about a quarter of the health facilities offering screening services between 2015 and 2018. This is alarming given that Kenya has been implementing a national screening program in the past 10 years. Additionally, with the high level of awareness among Kenyan women reported by it is expected that uptake of cancer screening should be high ( 16 ). Thus, there could be other factors contributing to the low screening uptake. Therefore, this study aimed to assess the prevalence and factors associated with cervical cancer screening among women aged 18-49 years in Bureti Constituency, Kericho County. RESEARCH METHODS AND DESIGN Study design and setting The study adopted an institution-based cross-sectional study design. The study was carried out among women aged 18 to 49 years who attended Kapkatet Sub-County Hospital in Kericho County during the study period. The hospital is a major healthcare facility in Bureti Constituency, located in the rural setting. The inclusion criteria comprised consented participants, women aged 18-49 who attended Kapkatet Sub-County Hospital. Women who were severely ill; unable to speak or hear; and lived in the study area for less than 6 months were excluded from the study. Variables This study investigated uptake and factors such as sociodemographic and knowledge related factors that influence cervical cancer screening utilization. Sociodemographic factors included age, religion, marital status, education attainment, employment status, household monthly income, age at first marriage, family history of cervical cancer, parity, sexual partners, and distance to the nearest health facility. Knowledge and uptake of cervical cancer included variables such as awareness of cervical cancer, patient, screening and screened persons, and knowledge on risk factors, signs and symptoms, preventive measures and groups at risk. Additionally, dependent variable was uptake of cervical cancer screening. Sample Size and Sampling Technique Sample size was determined using Fischer’s formula as described by Fisher et al. ( 17 ) and assumed uptake of 50% and error margin of 5%. The study achieved response rate of 85.4% (n = 328). Systematic random sampling technique was used to select 328 women aged 18 to 49 years attending mother and child health clinic. Eligible women were selected based on their arrival at the facility during study period. The first eligible woman was selected randomly while the rest were selected based on their arrival at predetermined sampling interval of 2 nd woman who arrives at the clinic. This continued for a period of 3 months, with keen to double selection of already enrolled participants. Data Collection Tool and Procedure This study collected data from January to March 2023 using structured questionnaires administered by trained and experienced research assistants under supervision of principal researcher. The questionnaires were pretested, customized, standardized and adapted from various studies ( 18 , 19 ). The questionnaire had three sections; sociodemographic characteristics, awareness and knowledge and screening uptake. Sociodemographic section entailed 11 items asked questions related to participant’s age, religion, marital status, education attainment, employment status, household monthly income, age at first marriage, family history of cervical cancer, parity, sexual partners, and distance to the nearest health facility. Awareness and knowledge section focused on questions that focused on awareness of cervical cancer, patient, screening and screened persons, and knowledge on risk factors, signs and symptoms, preventive measures and groups at risk. Additionally, cervical cancer screening uptake section was assessed through a dichotomous question (recorded as yes/no responses), that focused to ascertain whether or not they had ever undergone screening. Informed consent was sought from each participant prior enrollment to the study; only who gave and met inclusion criteria were included. Data Analysis Collected data was checked for completeness, cleaned, coded, and analyzed using Statistical Package for Social Science software version 20.0. Descriptive analyses were done for all variables, and summarized using frequencies and percentages. Knowledge related factors were transformed into one single variable scored as poor or good. Those who scored a cut off of 50% and above were regarded to have good knowledge while those who failed were regarded poor. This categorization was based on predefined cut-off scores derived from a scoring system developed through consensus among researchers familiar with the subject matter. Binary logistic regression analyses were conducted to assess association between the sociodemographic and knowledge related factors, and screening uptake. Results summarized using adjusted odds ratio, 95% confidence interval, and p-values. A p value of < 0.05 was considered significant. Ethical Considerations The study obtained ethical approval from the University of Kabianga Institutional Scientific and Ethical Research Committee (ISERC/2022/0154). Ethical clearance was also acquired from the Kenyan National Commission for Science, Technology, and Innovation (NACOSTI/P/23/25008). Permission was sought from the medical superintendent of the hospital. All recruited participants were informed about the objectives of the research. Written informed consent was obtained from each study participant. The names of respondents were not written on the questionnaire, but instead, a unique code was used to identify each participant and all information that was obtained from the health institution and respondents was kept strictly confidential. The written consent forms were kept in a lockable cabinet which could only be accessed by the investigators. RESULTS Socio-demographic Characteristics of Study Participants The study included a total of 328 women of reproductive age. Out of 328 respondents, 48 (33.1%) were aged 18–24 years, were Christians (97.2%), were married (50.3%), had attained secondary education (34.5%), main source of income was business (39.3%), and less than Ksh. 2, 000 (46.9%). Most of the respondents had two to four children (53.8%), had no multiple sex partners (56.6%), and had no family history of cervical cancer (98.6%). Out of 96 respondents who have ever been married, 63.5% were first married at the age of 18 years or below. Table 1 . View this table: View inline View popup Table 1. Socio-demographic Characteristics of Study Respondents Prevalence of cervical cancer screening The prevalence of cervical cancer screening was 16.2% (95% CI: 10.5-23.4). Figure 1 . Download figure Open in new tab Figure 1. Prevalence cervical cancer screening among the respondents Awareness and Knowledge Related to Cervical Cancer Screening Services Table 2 reveals that all the respondents who screened were aware of cervical cancer, 67.8% knew at least one cervical cancer patient, all had heard cervical cancer screening, and 92.5% knew at least someone who had screened. Additionally, among those who screened, majority had good knowledge on risk factors of cervical cancer (88.7%), its signs and symptoms (69.8%), and groups at risk of cervical cancer. However, more than half (54.7%) of screened women had poor knowledge on preventive measures of cervical cancer. View this table: View inline View popup Table 2. General knowledge and related to cervical cancer risks, signs, prevention, risk groups among women Association between sociodemographic factors and cervical cancer screening Women who aged 34 years and above were more likely to be screened (aOR: 1.43, 95% CI: 1.11 – 2.52, p < 0.001) compared to those who aged 18–24 years. Women who had attained primary education were more likely to be screened for cervical cancer (aOR: 3.83, 95% CI: 1.72 – 8.54, p = 0.001) compared to those who had no formal education. Women who were self – employed (aOR: 5.98, 95% CI: 2.94 – 12.15, p < 0.001) and unemployed (aOR: 8.96, 95% CI: 2.74 – 29.27, p < 0.001) were more likely to be screened. Individuals who earned a total monthly household income Ksh. 2, 000 – 5, 000 (aOR: 0.36, 95% CI: 0.063 – 0.79, p = 0.011) and more than Ksh. 10, 000 (aOR: 0.13, 95% CI: 0.059 – 0.307, p < 0.001) were less likely to be screened compared to counterparts earning less than Ksh. 2, 000. Family history of cervical cancer is significantly associated with higher likelihood of screening (aOR: 2.14, 95% CI: 0.74 – 6.12, p = 0.016), while those who had their marriage at age above 18 years were less likely to be screened (aOR: 0.71, 95% CI: 0.048 – 0.97, p < 0.001). Table 3 . View this table: View inline View popup Table 3. Binomial logistic regression analysis of association between sociodemographic factors and cervical cancer screening Association between knowledge related factors and cervical cancer screening Women who did not know at least one cervical cancer patients (aOR: 0.62, 95% CI: 0.33 – 0.86, p < 0.001), unaware of cervical cancer screening (aOR: 0.71, 95% CI: 0.24 – 0.93, p = 0.039), and did not know at least one screened (aOR: 0.88, 95% CI: 0.38 – 0.94, p = 0.012) were significantly associated lower likelihood of screening. Similarly, women who had poor knowledge on risk factors of cervical cancer (aOR: 0.52, 95% CI: 0.30 – 0.64, p < 0.001), cervical cancer signs and symptoms (aOR: 0.43, 95% CI: 0.11 – 0.73, p < 0.001), and knowledge on groups at risk (aOR: 0.37, 95% CI: 0. 15 – 0.62, p < 0.001) were less likely to screen. Table 4 . View this table: View inline View popup Table 4. Binomial logistic regression analysis of association between awareness and knowledge related factors, and cervical cancer screening DISCUSSION Despite the fact that cervical cancer screening reduces the incidence and mortality rates associated with cervical cancer, women in most developing nations have reported significantly low screening utilization, particularly in Kenya. The results of this study revealed that the prevalence of cervical cancer screening was 16.2%. This finding is consistent studies by Ng’ang’a et al. and Ngetich et al. which reported cervical cancer screening uptake of 14.4% and 15%, respectively ( 15 , 20 ). Similarly, a study in Nigeria reported that only 16.2% of antenatal clinic attendees had screened for cervical cancer ( 21 ). According to Kenyan Demographic and Health Survey 2022 report reported that a national prevalence of cervical cancer screening of 16.7%, which is lower than projected 90-70-90 target by 2030, to achieve 70% cervical cancer screening uptake. Lower screening uptake might be attributed to inadequate awareness campaigns and stimulating factors that can promote the uptake of screening services. Therefore, integration of screening services at the community level and routine screening programs at the hospital are vital to boosting uptake of screening services. This study revealed that majority of the women who screened were aware of cervical cancer and its screening. Despite having had good knowledge on risk factors of cervical cancer, its signs and symptoms and groups at risk, they had poor knowledge on essential preventive and management measures of cervical cancer. Similarly, awareness of cervical cancer and its screening have been reported among screened women ( 22 – 24 ). Lower knowledge on preventive and management strategies such as importance role of screening in early detection of cervical cancer, is common among majority of screening eligible women in Africa ( 25 – 27 ). While intensification of community health education campaigns focuses to raise awareness on cervical cancer and its screening, its critical to emphasize on need for screening, and other available essential preventive and management options. The study revealed that socio-demographic factors such as age, level of education, employment status, household monthly income, family history of cervical cancer, and age at first marriage were significantly associated with cervical cancer screening. Women who aged 34 years and above, and attained primary education were more likely to be screened compared to counterparts aged 18–24 years and had no formal education, respectively. This result was consistent with studies that reported that young women had lower likelihood to uptake cervical cancer screening compared to older women ( 28 , 29 ). This might be attributed by perceived lower risk and cancer related morbidity and mortality among women of younger age groups, which hinder their intention and screening practices. Similarly, a study conducted by Ng’ang’a et al. reported that higher educational attainment was significantly associated with increased odds of screening ( 15 ). This is attributed to more exposure to information regarding cervical cancer and its screening. Inclusion women health in education curriculum, especially cervical cancer studies, promote utilization of screening and health seeking practices due to increased awareness and knowledge. Self – employed and unemployed women had significantly higher odds of being screened compared to employed. This result was consistent with a study by Alie et al. ( 28 ) and Woldetsadik et al. ( 30 ), which attributed this to fixed and rigid work schedules. Fixed work schedules and inadequate leave period might also hinder healthcare seeking behaviour among employed women. Family history of cervical cancer was significantly associated with higher likelihood of screening. This result was supported by findings from northern Ethiopia and Kenya ( 18 , 29 , 31 ). This can be explained by the fact that women with family history have been exposed to information about cervical cancer screening and are at risk of its development, making them more likely to be screened. This study also revealed that higher household income and marriage at the age of 18 years or more was significantly associated with lower odds of being screened. These results were in contrary with studies that found increased likelihood of screening uptake among women with the highest household monthly income compared to those from low-income backgrounds ( 6 , 32 ). This difference might be attributed to subsidized or free screening services campaign in the country aimed to promote early detection of cervical cancer through timely screening, its management and reduced morbidity and mortality rates, particularly among the economically disadvantaged population. Concurring with current study’s finding, study by Desta et al. ( 33 ) reported that early marriage was significantly associated with increased odds of cervical cancer screening uptake. This might be associated with early sexual debuts and higher fertility rates, hence increased contact with healthcare services for reproductive health. Additionally, the study found that women who were unaware of at least one cervical cancer patient, cervical cancer screening services and screened person were significantly associated with lower likelihood to screen for cervical cancer. These findings were consistent with studies conducted in China and Malta, which reported that unawareness of screening services was associated with lower uptake ( 34 , 35 ). A study reported that knowing someone with cancer and/or screened was significantly associated with good knowledge and higher likelihood of screening ( 36 ). Lack of adequate awareness and knowledge of cervical cancer screening services contributes to lower uptake. Awareness of peers who have utilized screening might influence others to uptake screening, as it might promote awareness of such key services. Similarly, the current study reported that women who had poor knowledge on risk factors and signs and symptoms of cervical cancer cervical cancer, and knowledge on groups at risk were less likely to screen. These findings concur with a study in Palestine, that reported poor knowledge of risk factors was associated with lower odds of screening ( 36 ). Studies have reported that good knowledge of cervical cancer risk factors and signs and symptoms increase likelihood of screen uptake ( 20 – 22 ). This might be attributed to inadequate awareness campaigns and insufficient dissemination of information. Therefore, integration of regular and message tailored community-based health education campaigns might improve knowledge on risk factors and signs and symptoms. Hence, improved utilization of cervical cancer screening services among women. Conclusion Cervical cancer screening is crucial for reducing incidence and mortality rates, but women in developing nations, particularly Kenya, have reported low utilization. The study revealed lower cervical cancer screening uptake compared to national prevalence and projected 70% screening uptake by 2030. This is due to insufficient information about cervical cancer and its screening, and inadequate promotional factors. Socio-demographic factors such as age, education attainment, employment status, household monthly income, family history and age at first marriage significantly influence screening for cervical cancer. Similarly, awareness of cervical cancer patient, cervical cancer screening and screened person, and knowledge on risk factors, signs and symptoms and groups at risk of cervical cancer significantly impact utilization its screening. This demonstrates urgent need for intensified community – based health education to enhance awareness and knowledge of women on cervical cancer and its screening, with emphasis on its role in addressing delayed or late cancer diagnosis. Additionally, tailoring of culture – sensitive messages and community empowerment would promote cervical cancer screening. Data Availability All relevant data are within the manuscript and its Supporting Information files. Conflict of Interest The authors declare that there are no conflicts of interests. Financial declaration There was no funding received for this study. Abbreviations CC Cervical Cancer MCH Maternal and child health OR Odds Ratio Pap Papanicolaou smear SPSS Statistical Package for Social Sciences VIA Visual Inspection of cervix with Acetic acid VILI Visual Inspection of cervix with Lugol’s Iodine References 1. ↵ Simbar M , Kiani Z , Nasiri Z , KhodaKarami N , Nazarpour S , Fakari FR , et al. The self-care situation analysis of reproductive-aged women in Tehran: a survey study . BMC Womens Health [Internet] . 2023 Dec 1 [cited 2025 Apr 24]; 23 ( 1 ): 1 – 11 . Available from : doi: 10.1186/s12905-023-02763-9 OpenUrl CrossRef 2. ↵ Sung H , Ferlay J , Siegel RL , Laversanne M , Soerjomataram I , Jemal A , et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries . CA Cancer J Clin [Internet] . 2021 May [cited 2025 Apr 24]; 71 ( 3 ): 209 – 49 . Available from : doi: 10.3322/caac.21660 OpenUrl CrossRef PubMed 3. ↵ MoH. Kenya National Cancer Control Strategy 2017 - 2022 [Internet] . Nairobi ; 2017 [cited 2025 Apr 24]. Available from: http://repository.kippra.or.ke/handle/123456789/2802 4. ↵ Kaur S , Sharma LM , Mishra V , Goyal MGB , Swasti S , Talele A , et al. Challenges in Cervical Cancer Prevention: Real-World Scenario in India . South Asian J Cancer . 2023 Jan 1; 12 ( 1 ): 9 – 16 . OpenUrl PubMed 5. ↵ Yang L , Boily MC , Rönn MM , Obiri-Yeboah D , Morhason-Bello I , Meda N , et al. Regional and country-level trends in cervical cancer screening coverage in sub-Saharan Africa: A systematic analysis of population-based surveys (2000–2020) . PLoS Med [Internet] . 2023 Jan 1 [cited 2025 Apr 24]; 20 ( 1 ): 1 – 18 . Available from : doi: 10.1371/journal.pmed.1004143 OpenUrl CrossRef 6. ↵ Kamanga P , Zhang B , Stones W. Factors associated with low utilisation of cervical cancer screening among urban women in Lilongwe, Malawi: a cross sectional study . BMC Womens Health [Internet] . 2023 Dec 1 [cited 2025 Apr 24]; 23 ( 1 ): 1 – 8 . Available from : doi: 10.1186/s12905-023-02324-0 OpenUrl CrossRef 7. ↵ Bray F , Laversanne M , Sung H , Ferlay J , Siegel RL , Soerjomataram I , et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries . CA Cancer J Clin [Internet] . 2024 Apr 4 [cited 2025 Apr 24]; 74 : 229 – 63 . Available from : doi: 10.3322/caac.21834 OpenUrl CrossRef 8. ↵ Bray F , Ferlay J , Soerjomataram I , Siegel RL , Torre LA , Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries . CA Cancer J Clin . 2018 Nov ; 68 ( 6 ): 394 – 424 . OpenUrl CrossRef PubMed 9. ↵ D’Augè TG , Giannini A , Bogani G , Dio C Di , Laganà AS , Donato V Di , et al. Prevention, Screening, Treatment and Follow-Up of Gynecological Cancers: State of Art and Future Perspectives . Vol. 50 , Clinical and Experimental Obstetrics and Gynecology . IMR Press Limited ; 2023 . p. 1 – 8 . OpenUrl 10. ↵ Singh D , Vignat J , Lorenzoni V , Eslahi M , Ginsburg O , Lauby-Secretan B , et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative . Lancet Glob Health . 2023 Feb 1; 11 ( 2 ): e197 – 206 . OpenUrl 11. ↵ Teklehaimanot DA , Mekuria AD , Dadi AF , Derseh BT . Precancerous lesion determinants in women attending cervical cancer screening at public health facilities in North Shoa Zone, Amhara, Ethiopia: an unmatched case-control study . BMC Womens Health . 2024 Dec 1; 24 ( 1 ): 1 – 9 . OpenUrl PubMed 12. ↵ Gaikwad V , Gaikwad S , Yalla S , Salvi P. A Prospective Comparative Study Between Pap Smear, Visual Inspection With Acetic Acid, Visual Inspection With Lugol’s Io-Dine, Colposcopy and Histopathology for Diagnosis of Cervical Intraepithelial Neo-Plasia and Early Carcinoma Cervix . Journal of Pharmaceutical Negative Results ¦ [Internet] . 2023 [cited 2025 Apr 24]; 14 ( 6 ): 1 – 9 . Available from: https://org/10.47750/pnr.2023.14.S02.219 OpenUrl 13. ↵ Kasyoki J , Kanyoni J , Musa T , Kasyoki PJ , Author C. Cervical Cancer Awareness in Lemotit Location, Kipkelion East Sub-County, Kericho County, Kenya . IOSR Journal Of Humanities And Social Science (IOSR-JHSS [Internet] . 2018 ; 23 ( 7 ): 46 – 54 . Available from: https://www.iosrjournals.org OpenUrl 14. ↵ Orumaa M , Innos K , Suurna M , Veerus P. Cervical cancer screening history among women diagnosed with cervical cancer in Estonia 2017-18 . Eur J Public Health . 2023 Feb 1; 33 ( 1 ): 64 – 8 . OpenUrl PubMed 15. ↵ Ng’ang’a A , Nyangasi M , Nkonge NG , Gathitu E , Kibachio J , Gichangi P , et al. Predictors of cervical cancer screening among Kenyan women: Results of a nested case-control study in a nationally representative survey . BMC Public Health [Internet] . 2018 Nov 7 [cited 2025 Apr 24]; 18 ( 3 ): 1 – 10 . Available from : doi: 10.1186/s12889-018-6054-9 OpenUrl CrossRef 16. ↵ Gebreegziabher ZA , Semagn BE , Kifelew Y , Abebaw WA , Tilahun WM . Cervical cancer screening and its associated factors among women of reproductive age in Kenya: further analysis of Kenyan demographic and health survey 2022 . BMC Public Health . 2024 Dec 1; 24 ( 1 ). 17. ↵ Fisher A , Laing J , Stoeckel J , Townsend J. Handbook for family planning operations research design [Internet] . Population Council ; 1991 [cited 2025 Apr 24]. 1 – 88 p . Available from: https://knowledgecommons.popcouncil.org/departments_sbsr-rh/980/ 18. ↵ Solomon K , Tamire M , Kaba M. Predictors of cervical cancer screening practice among HIV positive women attending adult anti-retroviral treatment clinics in Bishoftu town, Ethiopia: The application of a health belief model . BMC Cancer [Internet] . 2019 Oct 23 [cited 2025 Apr 24]; 19 ( 1 ): 1 – 11 . Available from : doi: 10.1186/s12885-019-6171-6 OpenUrl CrossRef 19. ↵ Kivistik A , Lang K , Baili P , Anttila A , Veerus P. Women’s knowledge about cervical cancer risk factors, screening, and reasons for non-participation in cervical cancer screening programme in Estonia . BMC Womens Health [Internet] . 2011 Sep 28 [cited 2025 Apr 24]; 11 : 1 – 6 . Available from: http://www.biomedcentral.com/1472-6874/11/43 OpenUrl 20. ↵ Ngetich E , Nzisa I , Osoti A. Uptake and determinants of cervical cancer prevention services among female college students in Kenya: A cross-sectional survey . 2020 ; Available from : doi: 10.1101/2020.05.04.076513 OpenUrl Abstract / FREE Full Text 21. ↵ Isara A , PC-Onyekwere C. Cervical cancer screening practices of antenatal clinic attendees in Garki Hospital Abuja, Nigeria . Journal of Medicine and Biomedical Research [Internet] . 2024 Jul 23 [cited 2025 Apr 23]; 23 ( 1 ): 12 – 9 . Available from : doi: 10.4314/jmbr.v23i1.4 OpenUrl CrossRef 22. ↵ Uchendu I , Hewitt-Taylor J , Turner-Wilson A , Nwakasi C. Knowledge, attitudes, and perceptions about cervical cancer, and the uptake of cervical cancer screening in Nigeria: An integrative review . Vol. 14 , Scientific African . Elsevier B.V .; 2021 . 23. Pieters MM , Proeschold-Bell RJ , Coffey E , Huchko MJ , Vasudevan L. Knowledge, attitudes, and practices regarding cervical cancer screening among women in metropolitan Lima, Peru: a cross-sectional study . BMC Womens Health [Internet] . 2021 Dec 1 [cited 2025 Apr 24]; 21 ( 1 ): 1 – 13 . Available from : doi: 10.1186/s12905-021-01431-0 . OpenUrl CrossRef 24. ↵ Tsegay A , Araya T , Amare K , Gtsadik F. Knowledge, attitude, and practice on cervical cancer screening and associated factors among women aged 15–49 years in Adigrat Town, Northern Ethiopia, 2019: A community-based cross-sectional study . Int J Womens Health . 2020 ; 12 : 1283 – 98 . OpenUrl PubMed 25. ↵ John-Akinola YO , Ndikom CM , Oluwasanu MM , Adebisi T , Odukoya O. Cervical Cancer and Human Papillomavirus Vaccine Knowledge, Utilisation, Prevention Educational Interventions and Policy Response in Nigeria: A Scoping Review . Cancer Control [Internet] . 2022 Sep 28; 29 : 10732748221130180 . Available from : doi: 10.1177/10732748221130180 OpenUrl CrossRef 26. Drokow EK , Fangninou FF , Effah CY , Agboyibor C , Zhang Y , Arboh F , et al. Cervical cancer survival times in Africa . Front Public Health [Internet] . 2022 [cited 2025 Apr 24]; 10 ( 1 ): 1 – 10 . Available from : doi: 10.3389/fpubh.2022.981383 OpenUrl CrossRef 27. ↵ Ampofo AG , Adumatta AD , Owusu E , Awuviry-Newton K. A cross-sectional study of barriers to cervical cancer screening uptake in Ghana: An application of the health belief model . PLoS One [Internet] . 2020 Apr 1 [cited 2025 Apr 24]; 15 ( 4 ): 1 – 16 . Available from : doi: 10.1371/journal.pone.0231459 OpenUrl CrossRef 28. ↵ Alie MS , Negesse Y , Ayenew M. Determinants of Cervical Cancer Screening Among Women Aged 30–49 Years Old in Four African Countries: A Cross-Sectional Secondary Data Analysis . Cancer Control [Internet] . 2023 Jan 1 [cited 2025 Apr 23]; 30 : 1 – 13 . Available from : doi: 10.1371/journal.pone.0270821 OpenUrl CrossRef 29. ↵ Bante SA , Getie SA , Getu AA , Mulatu K , Fenta SL . Uptake of pre-cervical cancer screening and associated factors among reproductive age women in Debre Markos town, Northwest Ethiopia, 2017 . BMC Public Health [Internet] . 2019 Aug 14 [cited 2025 Apr 24]; 19 ( 1 ): 1 – 9 . Available from : doi: 10.1186/s12889-019-7398-5 OpenUrl CrossRef 30. ↵ Woldetsadik AB , Amhare AF , Bitew ST , Pei L , Lei J , Han J. Socio-demographic characteristics and associated factors influencing cervical cancer screening among women attending in St. Paul’s Teaching and Referral Hospital, Ethiopia . BMC Womens Health . 2020 Apr 6; 20 ( 1 ). 31. ↵ Gebreegziabher ZA , Semagn BE , Kifelew Y , Abebaw WA , Tilahun WM . Cervical cancer screening and its associated factors among women of reproductive age in Kenya: further analysis of Kenyan demographic and health survey 2022 . BMC Public Health [Internet] . 2024 Dec 1 [cited 2025 Apr 23]; 24 ( 1 ): 1 – 11 . Available from : doi: 10.1186/s12889-024-18148-y OpenUrl CrossRef 32. ↵ Lofters AK , Vahabi M , Kim E , Ellison L , Graves E , Glazier RH . Cervical cancer screening among women from Muslim-majority countries in Ontario, Canada . Cancer Epidemiology Biomarkers and Prevention [Internet] . 2017 Oct 1 [cited 2025 Apr 24]; 26 ( 10 ): 1 – 7 . Available from : doi: 10.1158/1055-9965.EPI-17-0323 OpenUrl Abstract / FREE Full Text 33. ↵ Desta M , Getaneh T , Yeserah B , Worku Y , Eshete T , Birhanu M , et al. Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis . PLOS ONE Journal [Internet] . 2021 [cited 2025 Apr 24]; 18 ( 11 ): 1 – 22 . Available from : doi: 10.1371/journal.pone.0259339 OpenUrl CrossRef 34. ↵ Deguara M , Calleja N , England K. Cervical cancer and screening: Knowledge, awareness and attitudes of women in Malta . J Prev Med Hyg [Internet] . 2021 Jan 14 [cited 2025 Apr 24]; 61 ( 4 ): 1 – 9 . Available from : doi: 10.15167/2421-4248/jpmh2020.61.4.1521 OpenUrl CrossRef 35. ↵ Zhang B , Wang S , Yang X , Chen M , Ren W , Bao Y , et al. Knowledge, willingness, uptake and barriers of cervical cancer screening services among Chinese adult females: a national cross-sectional survey based on a large e-commerce platform . BMC Womens Health [Internet] . 2023 Dec 1 [cited 2025 Apr 24]; 23 ( 1 ): 1 – 11 . Available from : doi: 10.1186/s12905-023-02554-2 OpenUrl CrossRef 36. ↵ Elshami M , Thalji M , Abukmail H , Al-Slaibi I , Alser M , Radaydeh A , et al. Knowledge of cervical cancer risk factors among Palestinian women: a national cross-sectional study . BMC Womens Health [Internet] . 2021 Dec 1 [cited 2025 Apr 23]; 21 ( 1 ): 1 – 14 . Available from : doi: 10.1186/s12905-021-01510-2 OpenUrl CrossRef View the discussion thread. Back to top Previous Next Posted July 07, 2025. Download PDF Data/Code Email Thank you for your interest in spreading the word about medRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. 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