Abstract
BackgroundsCervical cancer (CC) incidence remains unacceptably high in Côte d’Ivoire. In an effort to prevent this malignant condition, a national CC screening program has been scaled up in the country. This study aimed at assessing CC screening uptake and its associated factors in Abidjan in 2018.MethodsA cross-sectional survey was conducted from July to September 2018 in the main healthcare facilities of three randomly selected out of the eight health districts of Abidjan. During the study period, a standardized questionnaire was administrated by research assistants to all women aged 25 to 55 years old, attending the three participating facilities. Demographics, knowledge on CC, personal history of CC screening and reasons for not attending CC screening were collected. A logistic regression model was computed to document factors associated with reported CC screening uptake.ResultsA total of 1158 women with a median age of 32 years (IQR [27–36]), including 364 (31.4%) with no formal education were included. Of those participants, 786 (67.9%) had ever heard about CC. CC screening uptake at least once was reported by 7.5% [95% CI: 6.0–9.0] participants. In multivariable analysis, being ≥45 years (aOR: 6.2 [2.3–17.2]), having a university level (aOR: 2.8 [1.2–6.6]) (versus non formal education) and access to mass campaign information (aOR: 18.2 [8.5–39.1]) were associated with a reported CC screening uptake. The main reported barriers to CC screening were unawareness towards CC screening (75.5%), negligence (20.5%), fear of CC detection (3.9%) and fear of additional costs (3.3%).ConclusionCC screening uptake remains low despite current initiatives to support awareness and prevention in Abidjan. Awareness campaigns need to be massively increased with the adjunction of tailored messages based on the level of women’s education to enhance the CC screening coverage and reach the WHO goal of CC elimination by 2030.
Highlights
Cervical cancer (CC) is the fourth most common cancer in women at a worldwide level with around 568,847 new cases and 311,365 deaths according the International Agency for Research on Cancer (IARC) [1]
In low and middle income countries (LMICs), as Pap smear alternative, World Health Organization (WHO) recommended the implementation of CC screening programs based on visual inspection (VI) or based on oncogenic Human papillomaviruses (HPVs) detection where available [3]
This study aimed at assessing CC screening uptake and its associated factors among women living in Abidjan, the economic capital of Côte d’Ivoire
Summary
Cervical cancer (CC) is the fourth most common cancer in women at a worldwide level with around 568,847 new cases and 311,365 deaths according the International Agency for Research on Cancer (IARC) [1]. Around 87% of the CC-related deaths occurred in low and middle income countries (LMICs) [2]. In 2018, approximately 1789 new cases and 1446 deaths were recorded in Côte d'Ivoire making this malignancy the second most common cancer and the leading cause of mortality by cancer in women [1]. In LMICs, as Pap smear alternative, World Health Organization (WHO) recommended the implementation of CC screening programs based on visual inspection (VI) or based on oncogenic HPV detection where available [3]. In the beginning of the last decade, some developing countries have successfully implemented pilot VI-based screening programs in HIV clinics before scaling up them outside HIV sites and towards their countries [4,5,6]
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