Determinants of cervical cancer screening uptake among women with access to free screening: A community-based study in peri-urban Ghana.

Abstract

Cervical cancer can be prevented by regular screening; however, screening rates are low in developing countries. We evaluated the proportion of women screened, modalities of screening utilized, and factors influencing uptake among Ghanaian women with access to free screening services. Participants were women aged 25-65 in Asokore-Mampong, Ghana. A structured questionnaire collected socio-demographic characteristics, risk factors, knowledge of, and utilization of cervical cancer screening. Adjusted logistic regression evaluated predictors of screening. Of 710 participants, the majority had heard of cervical cancer (64.6%) and screening (57.7%). Screening utilization was 24.6%. Visual inspection with acetic acid was the most common screening method (97.1%). For those who had never been screened, common reasons were believing they were healthy (21.7%), fearing pain (12.9%), lacking awareness of screening (11.8%), and being too busy (11.6%). Participants who were aged 35-44 (aOR 1.82; 95% CI 1.09-3.03; p=0.023), married (aOR 3.98; 95% CI 1.68-9.40; p=0.002), formally employed (aOR 9.31; 95% CI 2.86-30.35; p<0.001), and had higher cervical cancer knowledge (aOR 3.98; 95% CI 2.64-6.02; p<0.001) were more likely to have been screened. Despite geographic proximity to a health center that provides free cervical cancer screening, screening uptake among Ghanaian women remains low.