Understanding the Low Level of Cervical Cancer Screening in Masaka Uganda Using the ASE Model: A Community-Based Survey.

Cyprian Twinomujuni,Juliet Ndimwibo Babirye,Fred Nuwaha,Giampiero Favato

doi:10.1371/journal.pone.0128498

Cyprian Twinomujuni, Juliet Ndimwibo Babirye + Show 2 more

Open Access

https://doi.org/10.1371/journal.pone.0128498

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Journal: PloS one	Publication Date: Jun 1, 2015
Citations: 58	License type: CC BY 4.0

Affiliation: Makerere University

Abstract

Cervical cancer is one of the leading causes of cancer deaths among women globally and its impact is mostly felt in developing countries like Uganda where its prevalence is higher and utilization of cancer screening services is low. This study aimed to identify factors associated with intention to screen for cervical cancer among women of reproductive age in Masaka Uganda using the attitude, social influence and self efficacy (ASE) model. A descriptive community based survey was conducted among 416 women. A semi-structured interviewer administered questionnaire was used to collect data. Unadjusted and adjusted prevalence ratios (PR) were computed using a generalized linear model with Poisson family and a log link using STATA 12. Only 7% (29/416) of our study respondents had ever screened for cervical cancer although a higher proportion (63%, 262/416) reported intention to screen for cervical cancer. The intention to screen for cervical cancer was higher among those who said they were at risk of developing cervical cancer (Adjusted prevalence ratio [PR] 2.0, 95% CI 1.60–2.58), those who said they would refer other women for screening (Adjusted PR 1.4, 95% CI 1.06–1.88) and higher among those who were unafraid of being diagnosed with cervical cancer (Adjusted PR 1.6, 95% CI 1.36–1.93). Those who reported discussions on cervical cancer with health care providers (Adjusted PR 1.2, 95% CI 1.05–1.44), those living with a sexual partner (Adjusted PR 1.4, 95% CI 1.11–1.68), and those who were formally employed (Adjusted PR 1.2, 95% CI 1.03–1.35) more frequently reported intention to screen for cervical cancer. In conclusion, health education to increase risk perception, improve women's attitudes towards screening for cervical cancer and address the fears held by the women would increase intention to screen for cervical cancer. Interventions should also target increased discussions with health workers.

Highlights

Cancer of the cervix is the most common cancer among women in 45 countries, with global reports of more than 500,000 new cases and 270,000 deaths every year [1]
More than half (63%) of our study respondents reported intention to screen for cervical cancer, only 6.5% were ever offered that opportunity by health care workers, which may partly explain why the uptake of screening services was only 7% in this rural setting
The level of intention to screen may be related to a low risk perception towards cervical cancer and fear of cervical cancer diagnosis in our study population similar to that reported in other African populations

Summary

Introduction

Cancer of the cervix is the most common cancer among women in 45 countries, with global reports of more than 500,000 new cases and 270,000 deaths every year [1]. Developing countries report most (85%) of the new cases and 90% of the deaths. Intention to Use Cervical Cancer Screening Services cancer is the most frequent cancer among women with 4000 newly diagnosed cases annually, 80% of which present with advanced disease when cure is impossible [1,2]. Only 5% of women in developing countries have ever been screened for cervical cancer compared to 84% of their counterparts in developed countries [1,4]

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