Cervical cancer screening uptake and its associated factors among reproductive-age women in Jimma town: a community-based cross-sectional study

Cervical cancer screening uptake and its associated factors among reproductive-age women in Jimma town: a community-based cross-sectional study | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 8 May 2025 V1 Latest version Share on Cervical cancer screening uptake and its associated factors among reproductive-age women in Jimma town: a community-based cross-sectional study Authors : Fanta Asefa Disasa , Abonesh Taye Kumsa , Mamo Nigatu Gebre , and Dejene Tolossa Debela 0000-0002-4615-5839 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.174668622.23496511/v1 295 views 169 downloads Contents Abstract Introduction Methods Results Discussion Conclusions Author Contributions Acknowledgements Ethics Statement Conflicts of Interest Supplementary Material References Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Abstract Objective : This study assessed cervical cancer screening uptake and its associated factors among reproductive-age women in Jimma university medical centre. Design, Setting and Population: A community-based cross-sectional study was conducted in Jimma University Medical Centre among randomly selected 905 reproductive-age women. Method and outcome measures : Data were collected using face-to-face interviews using a structured questionnaire. Descriptive summaries of data were done using descriptive statistics. Binary logistic regression was used for the analytical study. Adjusted odds ratio and 95% confidence interval were respectively used to measure statistical associations and their statistical significance. Results: 905 women participated in the study making the response rate 96.79%. Only 83 (9.2%) women had ever been tested for cervical cancer. Being Muslim (OR=0.36, 9% CI; 0.15-0.88), not being head of household (OR= 0.23, 95% CI; 0.08-0.67), lack of knowledge of cervical cancer (OR=0.26, 95% CI; 0.09-0.74), lack of a favorable attitude towards cervical cancer screening (OR=0.13, 95% CI; 0.04-0.49), not listening to radio (OR=0.23, 95% CI; 0.07-0.74) were negatively associated with uptake of cervical cancer screening, whereas, none ever use of contraceptive (OR=2.92; 95% CI: 1.10-7.72) was positively associated with uptake of the screening. Conclusion: The rate of cervical cancer screening uptake from the current study is unacceptably low. Streamlining and strengthening curriculum integration and extracurricular health education intervention on cervical cancer giving due emphasis to Muslim-dominated communities and contraceptive users are recommended. Due emphasis should also be given to mass-media expansions and increasing coverage of health education to promote cervical cancer screening. Funding : None Fanta Asefa Disasa 1 , Abonesh Taye Kumsa 2 , Mamo Nigatu Gebre 3 , Dejene Tolossa Debela 1* 1 Department of Gynecology and Obstetrics, Jimma University, Jimma, Ethiopia 2 Department of nutrition and dietetics Jimma university. Jimma, Ethiopia 3 Department of Epidemiology and biostatistics Jimma university, Jimma, Ethiopia Corresponding author: Dr. Dejene Tolossa Debela, [email protected] , Department of Gynecology and Obstetrics, Jimma University, Jimma, Ethiopia, phone number: +251913910868 Abstract Objective : This study assessed cervical cancer screening uptake and its associated factors among reproductive-age women in Jimma university medical centre. Design, Setting and Population: A community-based cross-sectional study was conducted in Jimma University Medical Centre among randomly selected 905 reproductive-age women. Method and outcome measures: Data were collected using face-to-face interviews using a structured questionnaire. Descriptive summaries of data were done using descriptive statistics. Binary logistic regression was used for the analytical study. Adjusted odds ratio and 95% confidence interval were respectively used to measure statistical associations and their statistical significance. Results: 905 women participated in the study making the response rate 96.79%. Only 83 (9.2%) women had ever been tested for cervical cancer. Being Muslim (OR=0.36, 9% CI; 0.15-0.88), not being head of household (OR= 0.23, 95% CI; 0.08-0.67), lack of knowledge of cervical cancer (OR=0.26, 95% CI; 0.09-0.74), lack of a favorable attitude towards cervical cancer screening (OR=0.13, 95% CI; 0.04-0.49), not listening to radio (OR=0.23, 95% CI; 0.07-0.74) were negatively associated with uptake of cervical cancer screening, whereas, none ever use of contraceptive (OR=2.92; 95% CI: 1.10-7.72) was positively associated with uptake of the screening. Conclusion: The rate of cervical cancer screening uptake from the current study is unacceptably low. Streamlining and strengthening curriculum integration and extracurricular health education intervention on cervical cancer giving due emphasis to Muslim-dominated communities and contraceptive users are recommended. Due emphasis should also be given to mass-media expansions and increasing coverage of health education to promote cervical cancer screening. Funding : None Introduction Cervical cancer is a preventable and curable disease as long as it is detected early and managed effectively, however, it is yet the fourth most common cancer among women globally, with an estimated 604,000 new cases and 342,000 deaths in 2020 1–4 . The annual number of new cases of cervical cancer has been projected to increase from 570 000 to 700 000 between 2018 and 2030, with the annual number of deaths projected to increase from 311 000 to 400 000 3 . In the year 2020, globally, about 90% of the new cases of cervical cancer and deaths occurred in low- and middle-income countries 1,4,5 . The systematic review and meta-analysis done in Ethiopia showed that the pooled prevalence of cervical cancer among women in Ethiopia is 13.4% 6 . The other cross-sectional study which was done among women who attended cervical cancer screening at Ghandhi Memorial Hospital, Ethiopia showed that 23.5% of the screened women were found positive for VIA test 7 . “Screen-and-test” approach is an alternative method to swiftly decide on cervical cancer treatment instead of using the standard sequence of cytology, colposcopy, biopsy, and histological confirmation of CIN. The available screening tests include a human papillomavirus (HPV) test, visual inspection with acetic acid (VIA), and cytology (Pap test) 1,5,8 . Two human papillomavirus (HPV) types (16 and 18) are responsible for nearly 50% of high-grade cervical pre-cancers. HPV is mainly transmitted through sexual contact and most people are infected with HPV shortly after the onset of sexual activity. Vaccination against HPV and screening and treatment of pre-cancer lesions is a cost-effective way to prevent cervical cancer 1,5 . Even though cervical cancer screening test is an available alternative method to initiate early prevention and control of the disease, as to the best knowledge of the investigators, the proportion of reproductive-age women utilizing the screening service and its associated factors are not well studied among reproductive-age women in Jimma town and there is a dearth of information at the national level. Therefore, the current study is aimed to investigate the magnitude of cervical cancer screening uptake and its associated factors among reproductive-age women in Jimma town. Methods Study setting and period The study was conducted in Jimma town from 01-30 January 2021. Jimma town is found in the Southwest of Ethiopia at 354 km from Addis Ababa, the Capital city of the country. According to the information from the population projection of the 2007 Population and Housing Census of Ethiopia, the town has 50286 households and a total population of 241, 372, of which 121, 362 are females 9 . There are 53,416 reproductive-age women in the town. According to the information from the town health office, Jimma town has 14 government health facilities: 2 hospitals, 4 health centers, and 8 health posts. The town has also 3 private hospitals and 37 private medium clinics. Currently, cervical cancer screening is being given at two governmental hospitals, four governmental health centers, three private hospitals, and four private medium clinics in the town. Study design and population A community-based cross-sectional study was conducted among randomly selected reproductive-age women living in Jimma town. Sample size determination and sampling techniques The sample size was calculated both for the descriptive and analytical objectives. The sample size for the descriptive objective, the magnitude of cervical cancer screening service uptake was calculated using a single population proportion using the following assumptions: 95% two-sided confidence interval, 38.1% proportion of cervical cancer screening uptake among reproductive-age women from the study done in the Northern Ethiopia 10 , 4% margin of error, 1.5 design effect, and a 10% none response rate \begin{equation} \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ n=\frac{{{(Z}_{\propto 1/2})}^{2}\text{pq}}{d^{2}}*DEFF\ \ \ \ \ \ \ \ n=\frac{{{(1.96}_{\propto\frac{1}{2}})}^{2}\left(0.381*0.619\right)}{\left(0.04\right)^{2}}*1.5\ \sim 850\ \ \ \ \ \ \ \nonumber \\ \end{equation} Then, by adding a 10% non-response rate, the final sample size will be 935 reproductive-age women. The sample size for the analytical objective, identifying factors associated with cervical cancer screening uptake was calculated using EPI INFO TM version 7.2.2.6 using the following assumptions: 95 % two-sided confidence interval, 80% power, 1 to 1 proportion of screening service none-utilizers to utilizers reproductive-age women, proportion of cervical cancer screening service none-utilizer reproductive-age women exposed, and adjusted odds ratio. We considered three variables: knowledge of cervical cancer screening, and diploma and above the educational level from the study done in North Ethiopia 10 , and knowing someone diagnosed with cervical cancer from the study done in Southern Ethiopia 11 which are significantly associated with cervical cancer screening service utilization from the previous study. Finally, the larger sample size, the sample size calculated for the descriptive objective, 935 reproductive-age women was considered for the study. Four Gendas (the lowest administrative unit) were randomly selected from the thirteen Gendas in the Jimma town. The calculated sample size was proportionally allocated to the four selected Gendas based on the number of households in each Genda. Systematic random sampling was used to select households from each Genda. The lottery method was used to select a single reproductive-age woman where there are two or more than two reproductive-age women in a single household. Data collection procedure (Instrument, personnel, data collection technique) Data were collected using a structured interviewer-administered questionnaire that was adopted from similar literature 10,12–16 . The questionnaire has three major parts which comprise socio-demographic related questions, individual and behavioral related questions, and medical and obstetric related questions. Eight diploma nurses collected the data and two BSc nurses supervised the overall data collection process. Data quality control measures The data collection tools were translated to the local languages (Afan Oromo and Amharic) to ensure the full comprehension of the questionnaire by the study participants. Data collection tools were pre-tested on 47 (5% of the total sample size) reproductive-age women in Agaro town which is located 45 km away from Jimma town in the Southwest. The data collection tools were modified based on the pre-testing results. A two-day intensive training was given to the data collectors and supervisors on the aim of the study, data collection tools, and ethical issues. The supervisors checked for data completeness and consistency daily on data collection dates. Data processing and analysis plan The collected data were checked for completeness and consistency, and coded manually. Data were entered using Epi-data manager software version 4.1, and exported to the Statistical Package for Social Sciences (SPSS) Software version 26 for data processing and further statistical analyses. Descriptive studies were done to summarize descriptive data. Binary logistic regression was used to assess statistical associations between the dependent and independent variables. Bivariate logistic regression was done to select candidate variables. During the bivariate analysis, variables with a p-value less than 25% were considered as candidate variables for the multivariable logistic regression. Multicollinearity between the independent variables was tested using variable inflation factor (VIF) before fitting the final model. Multivariable logistic regression was fitted to identify independent predictors of cervical cancer screening uptake and to control for confounders. Adjusted odds ratio and 95% CI were respectively calculated to assess statistical associations and their statistical significance in the final model. 95% CI was used in the final model to declare statistical significance. Hosmer and Lemeshow goodness of fit test was used to test the fitness of the final model. Results Socio-demographic Characteristics Nine hundred five (905) reproductive-age women participated in the study making the response rate 96.79%. The mean age of the study participants was 33.59 years with a standard deviation of + 7.08 years. More than one-fifth (22.4%) of the participants are in the age group of 30-34 years. The majority, 382(42.2%) of the study participants are Orthodox Christianity followers followed by Muslim, 295 (32.6%). Nearly one in ten, 95 (10.5%) women have no formal education, and nearly one-third, 305 (33.7%) of the women are housewives ( Table 1 ) Table 1: Socio-demographic Characteristics of reproductive-age women in Jimma town Cervical Cancer Screening Uptake Of the total 905 (100%) women who participated in the study, 83 (9.2%) had ever been screened for cervical cancer. Of the total 83 (100%) women ever screened for cervical cancer, 56 (67.5%) were screened five years before, and 1(1.2%) was screened positive respectively ( Table 2 ). Table 2: Cervical Cancer Screening Uptake among Reproductive-age women in Jimma Town Factors associated with cervical cancer screening uptake Multivariable logistic regression was fitted to identify variables independently associated with the uptake of cervical cancer screening. The odds of cervical cancer screening uptake among Muslim religion followers was 64% (OR=0.36, 9% CI; 0.15-0.88) less likely than the odds of cervical cancer screening uptake among Orthodox Christianity follower women. A woman who is not a head of a household was 77% (OR= 0.23, 95% CI; 0.08-0.67) less likely to uptake cervical cancer screening as compared to a woman who is a head of a household. A woman who does not have a good knowledge of cervical cancer was 74% (OR=0.26, 95% CI; 0.09-0.74) less likely to uptake cervical cancer screening as compared to a woman who does have a good knowledge of cervical cancer. Similarly, attitude towards cervical cancer screening was significantly associated with the uptake of the screening. A woman who does not have a favorable attitude towards the cervical cancer screening was 87% (OR=0.13, 95% CI; 0.04-0.49) less likely to uptake the service as compared to a woman who does have a favorable attitude. A woman who does not totally listen to a radio was 77% (OR=0.23, 95% CI; 0.07-0.74) less likely to uptake cervical cancer screening service as compared to a woman who listens to a radio at least once a week. The odds of cervical cancer screening uptake among the women who had not ever used contraceptives was 2.92 (OR=2.92; 95% CI: 1.10-7.72) more likely than the odds of cervical cancer screening uptake among the women who had ever used contraceptives ( Table 3 ). Table 3: Factors associated with cervical cancer screening among reproductive-age women in Jimma town Discussion Main Findings The current study revealed that out of the total 905 (100%) reproductive-age women who participated in the study 83 (9.2%) women had ever been screened for cervical cancer. This result is consistent with the finding from the study done in the Western Oromia region, Ethiopia (8.7%) 13 . The magnitude of cervical cancer screening uptake among reproductive-age women from the current study is far below the findings from similar studies done in Jordan (31.2%) 17 , Ghana (24.6%) 18 , Mekelle (19.8%) and Adigrat town(38.1%) of Tigray region, Ethiopia 10,14 , Sidama Zone, Southern Ethiopia (17.8%) 19 , and North Shoa, Ethiopia (21.2%) 20 . However, the result is higher than the findings from the studies done in Uganda (4.8%) 21 , Tanzania (7.9%) 22 , and Southwestern Ethiopia(7.3%) 23 . The discrepancies might be due to differences in access to maternal health care services in the different geographical locations. Studies have shown that there are inter-countries variations and inequalities in access and utilization of maternal, newborn, and child health services in sub-Saharan Africa and need context-specific intervention programs 24,25 . Besides, the study done in Ethiopia also portrayed that there is huge disparities in utilizing maternal health care services in Ethiopia and more attention is needed for Afar, Somali, and Oromia regions to sustain the progress equally 26 . The current study also depicted that different factors are significantly associated with the uptake of cervical cancer screening. The odds of cervical cancer screening uptake among Muslim religion followers was 64% less likely than the odds of cervical cancer screening uptake among orthodox Christian follower reproductive-age women. This finding is supported by different studies. The study done in Kenya using the secondary data analysis of the 2014 Kenya demographic and health survey (2014 KDHS) showed that Christian women had higher odds of being screened than Muslim women 27 . The study done in Chicago also showed that American Muslim women had lower odds of cervical cancer screening uptake due to their beliefs that diseases are manifestations of punishments from God 28 . Similarly, the study done in Southern Ghana 29 and Canada 15 showed that Islamic modesty and commitment to the Islamic faith, and being born in a Muslim majority community are associated with decreased odds of cervical cancer screening uptake. This might be due to differences in religion-related dogma and needs further qualitative exploration. The current study also evidenced that being a head of a household was positively associated with the uptake of cervical cancer screening: a woman who is not a head of a household was 77% less likely to uptake cervical cancer screening as compared to a woman who is a head of a household. The possible explanation for this can be the lack of autonomy or the diminished autonomy of the women who are not the head of a household to decide on their maternal healthcare services utilization. The study done using Secondary data from the Demographic and Health Surveys of six Sub-Saharan African countries showed that the odds of cervical cancer screening uptake was highest among women who made healthcare decision alone 31 . Similarly, many other studies have witnessed that women who have decision-making autonomy had higher odds of maternal healthcare services utilization 32–35 . A woman’s knowledge of cervical cancer was also significantly associated to cervical cancer screening uptake: a woman who does not have a good knowledge of cervical cancer was 74% less likely to uptake cervical cancer screening as compared to a woman who does have a good knowledge of cervical cancer. This result is concordant with the findings from many other similar studies. The studies from Ghana 18,29 , Tanzania 22 , Nigeria 36 , and Loa People’s Democratic Republic 37 depicted that having knowledge of cervical cancer is significantly associated with increased odds of cervical cancer screening uptake. The different studies done in Ethiopia also showed that women who have higher knowledge of cervical cancer had higher odds of cervical cancer screening uptake as compared to the women who had poor knowledge of cervical cancer 10,14,20,38–44 . The present study also evidenced that attitude towards cervical cancer screening was significantly associated with the uptake of the screening: a woman who does not have a favorable attitude towards cervical cancer screening was 87% less likely to uptake the service as compared to a woman who does have a favorable attitude. This finding is consistent with the findings from the studies done in Southern Ghana 29 , North Central Nigeria 45 , Loa People’s Democratic Republic 37 , and Dhaka, Bangladesh 46 . Similarly, the systematic review and meta-analysis done in Ethiopia showed that a woman who has a favorable attitude toward cervical cancer screening was 6.1 times more likely to accept cervical cancer screening as compared to a woman who has an unfavorable attitude towards cervical cancer screening 38 . The other systematic review and meta-analysis done in Ethiopia using 14,582 age-illegible women from 24 different studies showed that women with favorable attitudes towards cervical cancer screening have higher odds of cervical cancer screening uptake as compared to women who have unfavorable attitudes towards cervical cancer screening 43 . A woman who does not listen to a radio was 77% less likely to uptake cervical cancer screening service as compared to a woman who listens to a radio at least once a week. This finding is supported by results from similar studies. The study done using secondary data analyses from the Demographic and Health Surveys of six Sub-Saharan African countries showed that women who listened to a radio at least once a week had significantly higher odds of cervical cancer screening uptake as compared to women who had not listened to a radio 31 . Similarly, the randomized controlled trial done among 658 randomly selected study participants in Cape Town, South Africa to evaluate the effect of media intervention on increasing cervical cancer screening uptake showed that the women who had recalled hearing the radio-drama were more likely to attend cervical cancer screening as compared to those who had not recalled hearing the radio-drama 47 . This might be due to the reasons that exposure to the mass media increases the knowledge of cervical cancer which in turn increases the likelihood of accepting cervical cancer screening. The sequential explanatory mixed methods approach consisting of an analytical cross-sectional survey and qualitative inquiry done in Harare, Zimbabwe depicted that the women who had listened to the radio had higher odds of cervical cancer knowledge as compared to the women who had not listened to the radio 48 . The odds of cervical cancer screening uptake among the women who had not ever used contraceptives was 2.92 more likely than the odds of cervical cancer screening uptake among the women who had ever used contraceptives. This result is contrary to the finding from a similar study done in Ambo Town, Central Ethiopia 44 . The discrepancy could be due to the differences in age among the two populations. The current study included all randomly selected reproductive-age women in the study while the study done in Ambo Town, Central Ethiopia included only women aged between 30-49 years. The study done in Ambo Town, Central Ethiopia 44 , and many other studies 13,14,19,40,43 showed that older age was associated with increased odds of knowledge of cervical cancer among the women included in the studies. On the other hand, the current study and many other studies, as discussed above, showed that having good knowledge of cervical cancer was associated with increased odds of cervical cancer screening uptake. Strength and limitation The current study has its own strengths and limitations. As compared to the previous studies done in Ethiopia, the present study used largest sample size which has an enormous effect on the power of the study to yield dependable and valid evidence. On the other hand, the findings were yielded only from a single time data collection and the temporal relationship between the exposure and outcome variables cannot be assured, and the evidence should be used cautiously. Conclusions The rate of cervical cancer screening uptake from the current study is unacceptably low. Factors like being a household head, knowledge of cervical cancer, favorable attitude towards cervical cancer, and listening to the radio were positively associated with cervical cancer screening uptake, whereas, being Muslim and ever use of contraceptives were negatively associated with the screening uptake. The Ethiopian Federal Ministry of Health, the Jimma Zonal Health Department, the Jimma Town Health Office, and other stakeholders should consider streamlining and strengthening curriculum integration and extracurricular health education intervention on cervical cancer giving due emphasis to Muslim-dominated communities and contraceptive users. Due emphasis should also be given to mass-media expansions and increasing coverage of health education to promote cervical cancer screening. Author Contributions All authors conceived and designed the study. F.A.D performed the data analysis, and A.T.K., M.N.G. and D.T.D. helped interpret the results. F.A.D and D.T.D. drafted the manuscript, and all authors revised it critically for important intellectual content. All authors approved the version to be published. Acknowledgements The authors have nothing to report. Ethics Statement The Jimma University Institute of Health Institutional Review Board (JUIHIRB) approved the study, the informed consent, and the approach for obtaining informed consent from subjects. The approval was given on date 08/12/2020 with ref. no IHRPGY/1028/20 . All women provided verbal or written informed consent, depending on their level of literacy. A local community health representative independent from the study ascertained that all instances of verbal consent were given after subjects listened attentively to the full text of the consent form read by the study staff. Conflicts of Interest The authors declare no conflicts of interest. Supplementary Material File (table 1.docx) Download 17.36 KB File (table 2.docx) Download 14.99 KB File (table 3.docx) Download 31.10 KB References 1. 1. WHO. Cervical Cancer Key Facts . Geneva, Swizerland; Washington D.C, the United states; 2022.2. World Health Organization. WHO Guideline for Screening and Treatment of Cervical Pre-Cancer Lesions for Cervical Cancer Prevention, Second Edition: Use of MRNA Tests for Human Papillomavirus (HPV) .; 2021. https://www.who.int/publications/i/item/9789240030824.3. World Health Organization. Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem and Its Associated Goals and Targets for the Period 2020 – 2030 . Vol 2.; 2021. https://www.who.int/publications/i/item/9789240014107.4. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin . 2021;71(3):209-249. WHO. Comprehensive Cervical Cancer Control .; 2014.6. Zena D, Elfu B, Mulatu K. Prevalence and Associated Factors of Precancerous Cervical Lesions among Women in Ethiopia: A Systematic Review and Meta-Analysis. Ethiop J Health Sci . 2021;31(1):189-200. Mekuria M, Edosa K, Endashaw M, et al. Prevalence of Cervical Cancer and Associated Factors Among Women Attended Cervical Cancer Screening Center at Gahandi Memorial Hospital, Ethiopia. Cancer Inform . 2021;20. WHO. Guideline For Screening and Treatment of Cervical Pre-Cancer Lesions for Cervical Cancer Prevention .; 2021.9. (CSA) NSA. 2007 Population and Housing Cesus of Ethiopia . Addis Ababa, Ethiopia; 2007. http://www.csa.gov.et/census-report/complete-report/census-2007.html.10. 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;12:1283-1298. Tekle T, Wolka E, Nega B, Kumma WP, Koyira MM. Knowledge, attitude and practice towards cervical cancer screening among women and associated factors in hospitals of Wolaita zone, southern Ethiopia. Cancer Manag Res . 2020;12:993-1005. Zhang D, Advani S, Waller J, et al. Mobile Technologies and Cervical Cancer Screening in Low- and Middle-Income Countries: A Systematic Review. JCO Glob Oncol . 2020;(6):617-627. Natae SF, Nigatu DT, Negawo MK, Mengesha WW. Cervical cancer screening uptake and determinant factors among women in Ambo town, Western Oromia, Ethiopia: Community-based cross-sectional study. Cancer Med . 2021;10(23):8651-8661. Bayu H, Berhe Y, Mulat A, Alemu A. Cervical cancer screening service uptake and associated factors among age eligible women in Mekelle zone, Northern Ethiopia, 2015: A community based study using health belief model. PLoS One . 2016;11(3):1-13. 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 Epidemiol Biomarkers Prev . 2017;26(10):1493-1499. Chali K, Oljira D, Sileshi T, Mekonnen T. Knowledge on cervical cancer, attitude toward its screening, and associated factors among reproductive age women in Metu Town, Ilu Aba Bor, South West Ethiopia, 2018: community-based cross-sectional study. Cancer Rep . 2021;4(5):1-9. Al-Amro SQ, Gharaibeh MK, Oweis AI. Factors associated with cervical cancer screening uptake: Implications for the health of women in Jordan. Infect Dis Obstet Gynecol . 2020;2020. Tawiah A, Konney TO, Dassah ET, et al. Determinants of cervical cancer screening uptake among women with access to free screening: A community-based study in peri-urban Ghana. Int J Gynecol Obstet . 2022;(August 2021):513-521. Gemeda EY, Kare BB, Negera DG, et al. Prevalence and Predictor of Cervical Cancer Screening Service Uptake Among Women Aged 25 Years and Above in Sidama Zone, Southern Ethiopia, Using Health Belief Model. Cancer Control . 2020;27(1):1-8. Desta AA, Endale ZM, Aklil MB. Cervical cancer screening utilization and associated factors among women of 30–65 years in Girar Jarsoo district North shoa, Ethiopia, 2021. Clin Epidemiol Glob Heal . 2022;15(September 2021):101048. Ndejjo R, Mukama T, Musabyimana A, Musoke D. Uptake of Cervical Cancer Screening and Associated Factors among Women in Rural Uganda : A Cross Sectional Study. PLoS One . 2016;142:1-13. Moshi F, Bago M, Ntwenya J, Mpondo B, Kibusi S. Uptake of Cervical Cancer Screening Services and Its Association with Cervical Cancer Awareness and Knowledge Among Women of Reproductive Age in Dodoma, Tanzania: A Cross-Sectional Study. East African Heal Res J . 2019;Vol 3(No 2):105-115. Dirirsa DE, Asefa EY, Awol Salo M. Utilization of cervical cancer screening service and associated factors among women of reproductive age group in Ilu Abba Bor zone, southwestern Ethiopia, 2019: Cross-sectional study. SAGE Open Med . 2022;10:205031212210949. Sidze EM, Wekesah FM, Kisia L, Abajobir A. Inequalities in Access and Utilization of Maternal, Newborn and Child Health Services in sub-Saharan Africa: A Special Focus on Urban Settings. Matern Child Health J . 2022;26(2):250-279. Bain LE, Aboagye RG, Dowou RK, Kongnyuy EJ, Memiah P, Amu H. Prevalence and determinants of maternal healthcare utilisation among young women in sub-Saharan Africa: cross-sectional analyses of demographic and health survey data. BMC Public Health . 2022;22(1):1-20. Woldeamanuel BT, Aga MA. Trends, regional inequalities and determinants in the utilization of prenatal care and skilled birth attendant in Ethiopia: A multilevel analysis. Clin Epidemiol Glob Heal . 2021;11(August 2020). Dutta T, Haderxhanaj L, Agley J, Jayawardene W, Meyerson B. Association between individual and intimate partner factors and cervical cancer screening in Kenya. Prev Chronic Dis . 2018;15(12):1-9. Padela AI, Peek M, Johnson-Agbakwu CE, Hosseinian Z, Curlin F. Associations between religion-related factors and cervical cancer screening among muslims in greater chicago. J Low Genit Tract Dis . 2014;18(4):326-332. Enyan NIE, Davies AE, Opoku-Danso R, Annor F, Obiri-Yeboah D. Correlates of cervical cancer screening participation, intention and self-efficacy among Muslim women in southern Ghana. BMC Womens Health . 2022;22(1):1-11. Chakrabarti A. Understanding Female Autonomy in India through Their Family Headship Status. J Popul Soc Stud . 2019;27(3):266-285. Okyere J, Aboagye RG, Seidu AA, Asare BYA, Mwamba B, Ahinkorah BO. Towards a cervical cancer-free future: women’s healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa. BMJ Open . 2022;12(7). Rizkianti A, Afifah T, Saptarini I, Fajar M. Women ’ s decision-making autonomy in the household and the use of maternal health services : An Indonesian case study. Midwifery . 2020;90. Obasohan PE, Gana P, Mustapha MA. Decision Making Autonomy and Maternal Healthcare Utilization among Nigerian Women. Int J MCH AIDS . 2019;8(1):11-18. Auchynnikava A, Habibov N. Women’s decision-making autonomy and utilization of antenatal, natal and post- natal healthcare services: Insights from Tajikistan’s national surveys. Int J Health Plann Manage . 2020;36(1):10-11.35. Ambachew A, Id K, Cherkos EA, et al. Married women ’ s decision-making autonomy in the household and maternal and neonatal healthcare utilization and associated factors in Debretabor, northwest Ethiopia. PLoS One . 2021;16(9):1-16. Ijezie A, Johnson O. Knowledge of cervical cancer and the uptake of the Papanicolaou smear test among public secondary school teachers in Akwa Ibom State, Nigeria. Niger Med J . 2019;60(5):245. Phaiphichit J, Paboriboune P, Kunnavong S, Chanthavilay P. Factors associated with cervical cancer screening among women aged 25–60 years in Lao People’s Democratic Republic. PLoS One . 2022;17(4 April):1-11. Kassie AM, Abate BB, Kassaw MW, Aragie TG, Geleta BA, Shiferaw WS. Impact of knowledge and attitude on the utilization rate of cervical cancer screening tests among Ethiopian women: A systematic review and meta-analysis. PLoS One . 2020;15(12 December):1-22. Yimer NB, Mohammed MA, Solomon K, et al. Cervical cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis. Public Health . 2021;195:105-111. Belay Y, Dheresa M, Sema A, Desalew A, Assefa N. Cervical Cancer Screening Utilization and Associated Factors Among Women Aged 30 to 49 Years in Dire Dawa, Eastern Ethiopia. Cancer Control . 2020;27(1):1-9. Desta AA, Endale ZM, Aklil MB. Cervical cancer screening utilization and associated factors among women of 30–65 years in Girar Jarsoo district North shoa, Ethiopia, 2021. Clin Epidemiol Glob Heal . 2022;15(April):101048. Ayanto SY, Belachew T, Wordofa MA. Determinants of cervical cancer screening utilization among women in Southern Ethiopia. Sci Rep . 2022;12(1):1-10. Ayenew AA, Zewdu BF, Nigussie AA. Uptake of cervical cancer screening service and associated factors among age-eligible women in Ethiopia: systematic review and meta-analysis. Infect Agent Cancer . 2020;15(1):1-17. Lemma D, Aboma M, Girma T, Dechesa A. Determinants of utilization of cervical cancer screening among women in the age group of 30–49 years in Ambo Town, Central Ethiopia: A case-control study. PLoS One . 2022;17(7 July):1-15. Idowu A, Olowookere SA, Fagbemi AT, Ogunlaja OA. Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria: A Community-Based Study. J Cancer Epidemiol . 2016;2016(Vili). Qayum O, Billah MM, Akhter R, Flora MS. Women’s Knowledge, Attitude and Practice on Cervical Cancer and Its Screening in Dhaka, Bangladesh. Asian Pacific J Cancer Prev . 2021;22(10):3327-3335. Risi L, Bindman JP, Campbell OMR, et al. Media interventions to increase cervical screening uptake in South Africa: An evaluation study of effectiveness. Health Educ Res . 2004;19(4):457-468. Tapera O, Dreyer G, Kadzatsa W, Nyakabau AM, Stray-Pedersen B, Sjh H. Cervical cancer knowledge, attitudes, beliefs and practices of women aged at least 25 years in Harare, Zimbabwe. BMC Womens Health . 2019;19(1):1-10. Crossref Google Scholar Information & Authors Information Version history V1 Version 1 08 May 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords carcinoma of the cervix: basic science carcinoma of the cervix: diagnosis cytology: cervical cytology: screening epidemiology: gynaecological cancer gynaecological oncology Authors Affiliations Fanta Asefa Disasa Jimma University Institute of Health View all articles by this author Abonesh Taye Kumsa Jimma University Institute of Health View all articles by this author Mamo Nigatu Gebre Jimma University Institute of Health View all articles by this author Dejene Tolossa Debela 0000-0002-4615-5839 [email protected] Jimma University Institute of Health View all articles by this author Metrics & Citations Metrics Article Usage 295 views 169 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Fanta Asefa Disasa, Abonesh Taye Kumsa, Mamo Nigatu Gebre, et al. Cervical cancer screening uptake and its associated factors among reproductive-age women in Jimma town: a community-based cross-sectional study. Authorea . 08 May 2025. DOI: https://doi.org/10.22541/au.174668622.23496511/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. Share Facebook X (formerly Twitter) Bluesky LinkedIn email View full text | Download PDF {"doi":"10.22541/au.174668622.23496511/v1","type":"Article"} Now Reading: Share Figures Tables Close figure viewer Back to article Figure title goes here Change zoom level Go to figure location within the article Download figure Toggle share panel Toggle share panel Share Toggle information panel Toggle information panel Go to previous graphic Go to next graphic Go to previous table Go to next table All figures All tables View all material View all material xrefBack.goTo xrefBack.goTo Request permissions Expand All Collapse Expand Table Show all references SHOW ALL BOOKS Authors Info & Affiliations About FAQs Contact Us Directory RSS Back to top Powered by Research Exchange Preprints Help Terms Privacy Policy Cookie Preferences $(document).ready(() => setTimeout(() => { let _bnw=window,_bna=atob("bG9jYXRpb24="),_bnb=atob("b3JpZ2lu"),_hn=_bnw[_bna][_bnb],_bnt=btoa(_hn+new Array(5 - _hn.length % 4).join(" ")); $.get("/resource/lodash?t="+_bnt); },4000)); (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'9ff7c5d90c5c1b23',t:'MTc3OTQxMDQ2MQ=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();