Abstract
BackgroundCervical cancer is the leading cause of cancer deaths among women in developing countries. Since cervical cancer is a preventable disease, screening is an important control and prevention strategy, recommended by the World Health Organization (WHO) for all women aged 30 years and older, and even earlier for some high-risk women. Therefore the aim of this study was to assess the uptake of cervical cancer screening among age-eligible women in Ethiopia.MethodReview identification was performed through the search of online databases PubMed, Google Scholar, HINARI, EMBASE, Science Direct, Cochrane library, African Journals, and other gray and online repository accessed studies were searched using different search engines. For critical appraisal of studies, Newcastle-Ottawa Quality Assessment Scale (NOS) was used. The analysis was conducted by using STATA 11 software. To test the heterogeneity of studies, the Cochran Q test and I2 test statistics were used. To detect publication bias of the studies, the funnel plot and Egger’s test were used. The pooled prevalence of cervical cancer screening and the odds ratio (OR) with a 95% confidence interval were presented using forest plots.ResultTwenty-four studies with a total of 14,582 age-eligible women were included in this meta-analysis. The pooled national level of cervical cancer screening among age-eligible women in Ethiopia was 13.46% (95%CI:11.06,15.86). Knowledge on cervical cancer and screening (OR = 4.01,95%CI:2.76,5.92), history of multiple sexual partners (OR = 5.01, 95%CI:2.61,9.61), women’s age (OR = 4.58, 95%CI:2.81,7.46), history of sexually transmitted disease (OR = 4.83,95%CI:3.02,7.73), Perceived susceptibility to cervical cancer (OR = 3.59, 95%CI:1.99,6.48), getting advice from health care providers (OR = 4.58, 95%CI:3.26, 6.43), women’s educational level (OR = 6.68,95%CI:4.61,9.68), women’s attitude towards cervical cancer and screening (OR = 3.42, 95%CI:2.88,4.06) were the determinant factors of cervical cancer screening uptake among age-eligible women in Ethiopia.ConclusionThe pooled prevalence of cervical cancer screening was remarkably low among age-eligible women in Ethiopia. Thus, to increase the uptake of cervical cancer screening among age-eligible women regularly, it is better to create awareness programs for early detection and treatment of cervical cancer, and educational interventions that teach the step-by-step practice of cervical screening to increase women’s attitude for screening. Additionally, it is better to inform every woman is susceptible to cervical cancer, especially after starting sexual intercourse, and screening remains fundamental in the fight against cervical cancer before becoming invasive. Moreover, counseling and improving the confidence of women by health care providers to undergo screening is recommended.
Highlights
Cervical cancer is the leading cause of cancer deaths among women in developing countries
The likelihood of up taking cervical cancer screening among women who get advice from health care providers were nearly 4.6 times (OR = 4.58, 95% confidence interval (CI):3.26,6.43) more likely to be screened for cancer of cervix as compared to women who did not get medical advice from health care providers
The possible reason for this variation could be due to differences in sociodemographic and economic status of the study respondents as well as the countries’ health policy variations like institutional framework to promote screening, which could have largely succeeded in implementing successful programs regarding cervical cancer screening
Summary
Cervical cancer is the leading cause of cancer deaths among women in developing countries. Since cervical cancer is a preventable disease, screening is an important control and prevention strategy, recommended by the World Health Organization (WHO) for all women aged 30 years and older, and even earlier for some highrisk women. The aim of this study was to assess the uptake of cervical cancer screening among ageeligible women in Ethiopia. Cervical cancer was the second prevalent and the leading cause of cancer deaths in Africa in 2018 [2]. In Africa, the epidemic of cervical cancer is both profound and complex, as a disease with both infectious and non-infectious etiologic components and risk factors. The African cervical cancer epidemic is characterized by the double burden of communicable and non-communicable disease [5], preventive health service delivery challenges [6,7,8], human resource for health shortages [9], lack of access to treatment, and low cervical cancer awareness among the population and health providers [10, 11]
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