Utilization Of Cervical Cancer Screening Research Articles

Community and provider perceptions and experiences of cervical cancer screening in Rural Bolivia: a qualitative study

BackgroundDespite efforts to increase cervical cancer screening access in rural Bolivia, uptake remains low. Bolivia has one of the highest cervical cancer mortality rates in the Americas. As it redoubles efforts to deliver Universal Health Care, the Bolivian government needs information on the factors constraining cervical cancer screening access and utilization, especially in rural areas.MethodsOur qualitative study explored cervical cancer screening barriers and described community and provider perceptions and experiences of care. Bolivian and US researchers analyzed data collected from eight focus groups with male and female community members (n = 80) and interviews with healthcare providers (n = 6) in four purposively selected rural communities in Hernando Siles, Bolivia. Deductive and inductive codes were used to thematically analyze data using MaxQDA software.ResultsFour themes emerged from the data: lack of knowledge/misconceptions, health system inadequacy, lack of confidence in providers, and opportunities for improvement. Both men and women displayed misconceptions about the causes of cervical cancer, its consequences, the recommended screening frequency, and the means of accessing care. Providers noted community members’ lack of knowledge and low risk-perception as utilization barriers but also highlighted poor health service quality and inconsistent health education as factors. Poor healthcare quality was a significant barrier; this included poor patient-provider communication, lack of transportation to screening facilities, and severe delays in receiving test results. Providers also noted problems with provider training and physical space for screening. Community members reported low confidence in nurses to perform screening, preferring doctors and specialists. They also expressed discomfort in having male healthcare providers conduct screening. Suggestions for improvements included more intensive cervical cancer outreach to rural areas and having specialists train lower-level providers to perform screening.ConclusionsOur findings suggest that poor healthcare quality has affected screening uptake in addition to physical barriers to care. They indicate a need for initiatives to reduce reporting time for Pap test results, the incorporation of community-based HPV self-sampling into screening protocols, and the implementation of programs to improve community confidence in providers’ ability to perform screening.

Utilization of cervical cancer screening and its associated factors among women of child-bearing age in Mangochi district, Malawi: a facility-based cross-sectional study

BackgroundCervical cancer screening (CCS) uptake remains low in poor countries. Few studies have assessed individual need and health system factors which facilitate/impede use of healthcare services, including CCS utilization. Thus, we examined associations between these factors and CCS utilization among women of child-bearing age (WCBA) in Mangochi, Malawi.MethodsA cross-sectional study, sampling 482 women (18–49 years) using a multi-stage sampling method was conducted in five health facilities (HFs). Data were collected using a structured interview questionnaire from June-July, 2019. Chi-squared or Fisher’s exact tests were used to compare the distribution of CCS utilization according to different independent groups.ResultsOur study found that 13.1% of the study participants had a history of CCS. The proportion of WCBA with a history of CCS was significantly higher among HIV + women than HIV- women and women with unknown HIV status, respectively [27.3% (33/121) vs. 8.5% (30/353) vs. 0% (0/8), χ2 = 29.18, df = 2, p < 0.001]. Significantly higher among those who had ever heard of cervical cancer (CC) than those who had not [23.0% (60/261) vs. 1.4% (3/221), χ2 = 49.28, df = 1, p < 0.001], among those who heard of CC from HFs than those who heard through radios, friends/family and other sources, respectively [31.2% (44/141) vs. 16.7% (7/42) vs. 9.3% (5/54) vs. 16.7% (4/24), χ2 = 12.62, df = 3, p = 0.006], among those with positive beliefs towards CCS than those with negative beliefs [19.2% (53/276) vs. 4.9% (10/206), χ2 = 21.37, df = 1 p < 0.001], among those recommended for CCS by health workers (HWs) than those not recommended [19.6% (53/270) vs. 4.7% (10/212), χ2 = 23.24, df = 1, p < 0.001], among those willing to be screened by male HWs than those unwilling [14.4% (60/418) vs. 4.7% (3/64), χ2 = 4.57, df = 1, p = 0.033]. Fisher’s exact test showed that CCS uptake among WCBA varied significantly by level of knowledge of CC signs/symptoms, with 66.7% (12/18) and 19.8% (48/243) among those with high-level and low-level knowledge screened, respectively (p < 0.001).ConclusionsHIV status, ever heard of CC, sources of information, knowledge of CC signs/symptoms, beliefs, recommendations by HWs for CCS, willingness to be screened by male HWs were associated with CCS utilization. Thus, sensitization campaigns for CCS should be conducted to increase uptake. Further, health facilities should intensify health education on CC, including signs and symptoms to increase knowledge. In addition, CC program implementers should be willing to train both males and females to offer CCS as the clients are open to be attended to by male providers as well.

Cervical cancer screening utilization and associated factors among female health workers in public health facilities of Hossana town, southern Ethiopia: A mixed method approach.

Worldwide, a substantial proportion of women have low cervical cancer screening services utilization. There is a paucity of evidence in utilization of cervical cancer screening services among female health workers and inconsistent findings in Ethiopia. This study aimed to assess the utilization of cervical cancer screening services and associated factors among female health workers in public health facilities of Hossana town, Southern Ethiopia. Facility-based cross-sectional study design complemented with the qualitative inquiry was conducted among randomly selected 241 study participants in Hossana town from June 1 to July 1, 2021. Logistic regression models were used to determine the association between dependent and independent variables with the assumption of a variable with a p-value < 0.05 was considered statistically significant. Qualitative data were transcribed verbatim then translated to English and analyzed using open code version 4.03. Out of the total study participants, 19.6% was screened for cervical cancer. Having a diploma level of education (AOR = 0.48;95%CI:0.24,0.98), having three or more children (AOR = 3.65;95%CI:1.44,9.21), having multiple sexual partners(AOR = 3.89;95%CI: 1.38,11.01), and knowledge of cervical cancer screening (AOR = 2.66;95% CI:1.19,5.95) were statistically significantly associated with cervical cancer screening utilization. In-depth interviews suggested additional barriers for low screening utilization including lack of health educational materials, limitation of service to a specific area, service interruption, provider incompetency, and miss-trust and lack of attention by a trained provider. Utilization of cervical cancer screening service among female health workers is low. Having a diploma level of education, having three or more children, a history of multiple sexual partners, and knowledge about cervical cancer were predictors of cervical cancer screening utilization. Contextualized health talks and promotion through training with a special focus on low level of knowledge, had lower educational level, and the availability of cervical cancer screening services are critical.

Cervical cancer screening utilization and its predictors among women in bench Sheko Zone, Southwest Ethiopia: using health belief model

BackgroundCervical cancer is the fourth most frequently diagnosed and found to be the leading cause of cancer death in women, especially in low and middle-income countries. Even though cervical cancer is a preventable disease, its preventive measures have not been equitably implemented across and within different countries; especially in low and middle-income countries, due to different contributing factors.ObjectiveThis study aimed to assess cervical cancer screening utilization and its’ predictors among Women in Bench Sheko Zone, Southwest Ethiopia.MethodA community-based cross-sectional study design was employed in Bench Sheko Zone from February 2021 to April 2021. Using a multi-stage stratified sampling method, a total of 690 women in the age range of 30–49 years were included in the study. The logistic regression analysis was used considering a 95% confidence interval and a P-value of < 0.05.ResultsNinety-six (14.2%) of the participants have utilized cervical cancer screening. Predictors like; age between 40–49 years (AOR = 5.35, 95% CI = [2.89, 9.90]), partner educational status of certificate and above (AOR = 4.36, 95% CI = [1.65, 11.51]), first sexual intercourse before eighteen years (AOR = 4.85, 95% CI = [2.29, 10.26]), ever used of alcohol (AOR = 3.99, 95% CI = [1.23, 12.89]), good knowledge (AOR = 8.98, 95% CI = [4.06, 19.89]), favorable attitude (AOR = 3.56, 95% CI = [1.78, 7.09]), and high perceived benefit (AOR = 2.94, 95% CI = [1.48, 5.84]) were strongly associated with cervical cancer screening utilization.ConclusionIn this study, cervical cancer screening utilization was relatively low. Therefore, promotion of the perception of women towards cervical cancer screening, and provision of health-related information towards different behavioral-related factors should have to be addressed at each level of health care.

Cervical cancer screening utilization and associated factors among women attending antenatal care at Asella Referral and Teaching Hospital, Arsi zone, South Central Ethiopia

BackgroundCervical cancer is a major public health problem affecting women worldwide. It is the second cause of mortality among women in Ethiopia. Early Cervical cancer screening has a tremendous impact on reducing morbidity and mortality related to cervical cancer infection. Therefore, this study aimed to assess cervical cancer screening utilization and associated factors among women attending Antenatal Care at Asella referral and teaching hospital, Arsi Zone, south-central Ethiopia.MethodThis study employed a facility-based cross-sectional study among 457 Antenatal Care mothers from December 2020 to February 2021. Data collection was performed using interviewer-administered structured questionnaires. Data were entered into EpiInfo Version 7 and transferred to SPSS V.21 for analysis. A logistic regression model was used to determine the factors associated with cervical cancer screening utilization and an adjusted odds ratio with a 95% confidence interval at p-value < 0.05 was computed to determine the level of statistical significance.ResultThe magnitude of cervical cancer screening utilization was found to be 7.2%(95% CI: 5.2, 10.6). Educational status of secondary and above (AOR = 2.92; 95%CI = 1.078–7.94), getting screened for any reproductive healthcare services(AOR = 4.95; 95%CI = 2.24–10.94), having multiple sexual partners(AOR = 4.55; 95%CI = 1.83–11.35), and satisfactory knowledge of cervical cancer screening(AOR = 3.89; 95%CI = 1.74–8.56) were significantly associated factors with cervical cancer screening utilization.ConclusionUtilization of cervical cancer screening was low among women attending Antenatal care at Asella Referral and Teaching hospital, Southcentral Ethiopia. Educational status, history of multiple sexual partners, getting screened for any reproductive healthcare services, and knowledge of cervical cancer screening were significant factors associated with the utilization of cervical cancer screening. Hence, to improve the utilization of Cervical cancer screening, there should be the implementation of programmed health education and awareness creation on the benefits of screening as well as the promotion of reproductive healthcare services at health facilities.

Factors associated with low utilisation of cervical cancer screening among urban women in Lilongwe, Malawi: a cross sectional study

BackgroundIn 2012, more than half a million women (528,000) were diagnosed with cervical cancer around the world. More than 80% of cervical cancer occurs in developing nations, such as Malawi, where estimates of the disease’s burden show an incidence of 75.9 per 100,000 women and a mortality rate of 49.8 per 100,000 women (both age-adjusted). Despite its case fatality rate, cervical cancer can be avoided through immunization, early detection and screening. Malawi however, has low immunization and screening rates with coverage as low as 9% and 15%, respectively. Here our aim is to uncover factors that contribute to low utilization of cervical cancer screening services among women in Lilongwe, a large urban center.MethodsThis was a qualitative cross-sectional study. Participants were chosen at random from a big metropolitan health center. In-depth interviews and two observations were undertaken by the researchers. Interviews were taped, transcribed verbatim, and content assessed.ResultsA total of 24 women and 5 health workers, with an average age of 34.8 years, were questioned. 50% of women had completed secondary school, 33.3% had completed primary school, and 4% had completed no formal education. The majority of the women were housewives and entrepreneurs. 62.5% of the respondents had fewer than four children, 25% had four to six children, and 8.3% had more than six children. 91 − 6% of those surveyed were married, with 78% of Christians and 20% of Muslims. The majority of women were unaware of the importance of cervical cancer screening. Some people were concerned about marital troubles, pain during the process, “laziness,“ and the amount of time necessary. The majority of people would come for a test as a result of signs and symptoms. Male health personnel would be unable to screen Muslim women. All of the medical personnel had at least two years of experience. Women’s low involvement in cervical cancer screening has been linked by health workers to a lack of resources and a lack of community awareness.ConclusionCervical cancer can be prevented by early detection and treatment. Women, on the other hand, are uninformed about cervical cancer. Myths, misconceptions, cultural and religious beliefs, as well as service restrictions and community sensitization, influence the use of cervical cancer screening services. Addressing these issues has the potential to boost cervical cancer screening rates.

Cervical Cancer Screening Practice Among Women: A Community Based Cross-Sectional Study Design.

Early detection of cervical cancer through screening practice in developing countries is still low. The study is aimed to determine cervical cancer screening practice and associated factors among women of age 25 to 59 years old. Community-based study design was employed and systematic sampling was used to get 458 samples. The data were entered into Epi info version 7.2.1.0 and exported to SPSS version 20 for cleaning and analysis. Binary and Multivariable Logistic regression was used and adjusted odds ratio with 95% CI at P-value <.05 was reported as significant value. Cervical screening practice among the study participants was 15.5%. Women's age 40 to 49 (AOR = 2.95, 95% CI = 0.94, 9.28), educational status (AOR = 4.19, 95% CI = 1.31, 13.37), employed women (AOR = 2.59, 95% CI = 1.01, 6.68), parity above 4 (AOR = 3.09, CI = 1.03, 9.31), sexual partners 2 to 3 (AOR = 5.32, CI = 2.33, 12.14), good knowledge about cervical cancer (AOR = 3.88; 95% CI = 1.83, 8.23) and positive attitude toward cervical cancer (AOR = 5.92, CI = 2.53, 13.87) were independently associated with cervical cancer screening practices. The study revealed that the utilization of cervical cancer screening was very low. Educational status, Women's age, number of sexual partners, knowledge, and attitude were significantly associated with cervical cancer screening practice. Therefore, intervention programs intended at improving cervical cancer screening practice among women should focus on the significant factors.

Determinants of cervical cancer screening utilization among women attending health facilities of Dessie town, Northeast Ethiopia

IntroductionDespite the higher burden of cervical cases, screening programs in highly affected developing countries remained low. This made the disease to be present at an advanced stage which is almost always fatal, causing enormous pain and suffering for the individual and having significant adverse effects on the welfare of their families and community. Thus, this study aimed to assess determinants of cervical cancer screening utilization among women attending health facilities in Dessie Town, Northeast Ethiopia.MethodsAn institution-based unmatched case–control study design was employed on 430 women (146 cases and 284 controls) at selected health facilities of Dessie town, South Wollo Zone, from July 1/2020 to August 30/2020. Cases were selected for all women screened for cervical cancer during the data collection period until the required sample size was attained and using a consecutive sampling technique, every 3 participants from women who come for services other than cervical cancer screening. were included as controls. Pretested and structured questionnaires were used to collect the data. Data were analyzed by SPSS version 25 software. Bivariable and multivariable logistics regression analysis was done. An adjusted odds ratio with 95% CI was estimated to measure the strength of the association. The level of statistical significance was declared at a p-value < 0.05.ResultAge group of 35 and more [AOR = 11.52(6.09–21.77)], being a private employee [AOR = 4.67(2.41–9.03)], having symptoms of vaginal bleeding or pelvic pain or postcoital bleeding or vaginal discharge [AOR = 3.08(1.37–6.95)], being recommended by a physician for screening [[AOR = 3.07(1.45–6.49)] and positive attitude towards cervical cancer screening [AOR = 5.3(2.8–10.59)] were determinants of cervical cancer screening.ConclusionAge group of 35 and more, current occupation as a private employee, having symptoms of cervical cancer, being recommended by a physician for screening, and positive attitude towards cervical cancer screening were determinants of cervical cancer screening utilization.

Utilisation of cervical cancer screening and factors associated with screening utilisation among women aged 30–49 years in Mertule Mariam Town, East Gojjam Zone, Ethiopia, in 2021: a cross-sectional survey

ObjectiveTo assess the practice of cervical cancer screening and its associated factors among women aged 30–49 years.DesignCommunity-based cross-sectional survey.SettingMertule Mariam Town, Northwest Ethiopia, 1 May–20 June 2021.ParticipantsWomen aged 30–49 years...

Utilization of Cervical Cancer Screening and Associated Factors among Women in Bhaktapur, Nepal

Background Cervical cancer is the most common cancer among women in Nepal causing highest cancer mortality among women of reproductive age. However, it can be prevented through early and regular screening.&#x0D; Objective To assess utilization of cervical cancer screening, its awareness and perception among women, and associated factors.&#x0D; Method A cross-sectional study was conducted where 360 women of age 30-60 years were randomly selected and interviewed from five administrative wards of Bhaktapur municipality.&#x0D; Result Utilization of cervical cancer screening through Pap test or Visual Inspection with Acetic acid was found in 32.2% women and 47.8% were aware of cervical cancer and its screening tests. 100% of them had high level of perceived benefits and facilitators. More than 80% of them had low level of perceived barriers and susceptibility. Women of age group 51-60 years were more likely to perform the screening test (AOR=13.14) whereas unemployed women were at higher odds of performing the test (AOR=3.29). Women who were aware of cervical cancer and its screening were more likely to perform the screening (AOR=53.65). Women having low level of perceived barriers (AOR=5.83) and high level of perceived seriousness (AOR=6.67) were more likely to perform the screening.&#x0D; Conclusion Only one third of women had performed Pap test/VIA and those who were aware of cervical cancer and had high level of perception were more likely to perform the screening. Thus, more rigorous and tailor-made awareness programs should be developed by health program planners to increase the screening rate among younger and working women.

Determinants of cervical cancer screening utilization among women in Southern Ethiopia

Cervical cancer has been an important public health problem. Despite the availability of screening services, its utilization in Ethiopia is low. This study therefore, aimed to identify contextual predictors of cervical cancer screening utilization among eligible women. This study employed facility-based unmatched case–control study design. Data were collected from 410 participants using interviewer-administered techniques. The collected data were entered using EpiInfo version 7 and transported to SPSS version 20 for statistical analysis. We performed descriptive analysis and logistic regression to identify predictors of screening utilization. This study demonstrated that urban residence, being in marital union, membership in women development army, knowledge of cervical cancer screening location, use of maternal health care in the previous year and knowledge on cervical cancer and its screening were predictors of screening utilization. Therefore, it is important to improve women’s knowledge on cervical cancer, promote maternal health care use, disseminate health information through women’s groups and consider all positive effects of urban residence among rural women to improve screening utilization.

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.

Globally, cervical cancer is the second most common and the leading cause of death in women in low-income countries. It is one of the potentially preventable cancers, and an effective screening program can result in a significant reduction in the morbidity and mortality associated with this cancer; however, evidence showed that only a small percentage of the women were screened. As a result, predictors of cervical cancer screening usage among women in Ambo town, central Ethiopia, were identified in this study. Unmatched, a community-based case-control study was conducted among 195 randomly sampled women in the age group of 30-49 years in Ambo town from February 1 to March 30, 2020. Data was collected using an interviewer-administered questionnaire. Descriptive, bivariate, and multivariable binary logistic regression analysis was done using SPSS. A total of 195 study participants, sixty-five cases and one hundred thirty controls, participated in this study, making a response rate of 100%. Being in the age group of 30-34 years old (AOR = 0.2; 95% CI: 0.06-0.7), being Para five and above (AOR = 4.5; 95% CI: 1.4-14.1), modern contraceptive utilization (AOR = 5.4; 95% CI: 1.8-16.3) and having high-level knowledge regarding cervical cancer screening and its predisposing factors (AOR = 5.9; 95% CI: 2-17) were significantly associated with the utilization of cervical cancer screening. The age of women, parity, use of modern contraception, and level of knowledge regarding cervical cancer screening and its predisposing factors were the determinants of the utilization of cervical cancer screening among women. As a result, the media, the health bureau, and health professionals should advocate raising awareness about cervical cancer and its preventative methods, which are primarily focused on screening.

Lower Compliance with Cervical Cancer Screening Guidelines Among Vegetarians in North America.

Cervical cancer is preventable and treatable through regular screening and follow-up. However, the utilization of cervical cancer screening may vary widely based on individual lifestyles. The purpose of this study was to examine the differences in the adherence to cervical cancer screening guidelines in various dietary groups. Our study included 21,376 women from the United States and Canada, aged 30-69 from the Adventist Health Study-2, a large population-based prospective cohort study. Modified Poisson regression with robust variance estimation was used to determine the prevalence ratios of cervical cancer screening behavior in participants following five different dietary patterns (non-vegetarians, semi-vegetarians, pesco-vegetarians, lacto-ovo-vegetarians, and vegans). All analyses were adjusted for age, race/ethnicity, marital status, education, personal income, body mass index, smoking, alcohol use, exercise, and family history of all female cancer. Vegetarians, in general, had similar screening prevalence as non-vegetarians. However, vegans were 16% less likely to have had a Pap test compared to non-vegetarians (prevalence ratio (PR) = 0.84, 95% confidence interval 0.81-0.86). Women who were younger, Black, married, more educated, had a family history of all female cancer, had a higher income, and exercise reported higher compliance to a Pap test. It remains to be seen whether vegan women in Adventist Health-2 experience a higher incidence of cervical cancer or are diagnosed at a later stage compared to non-vegetarians.

Utilisation of cervical cancer screening among women living with HIV at Kenya's national referral hospital.

BackgroundIn 2009, Kenyatta National Hospital (KNH) integrated cervical cancer screening within HIV care using visual inspection with acetic acid (VIA) and Pap smear cytology.ObjectivesWe evaluated utilisation of cervical cancer screening and human papillomavirus (HPV) vaccination among women living with HIV (WLHIV) receiving HIV care at KNH.MethodFrom November 2019 to February 2020, WLHIV aged ≥ 14 years were invited to participate in a survey following receipt of routine HIV services. We assessed awareness of cervical cancer, uptake of cervical cancer screening, uptake of the HPV vaccine, and barriers to utilisation of these services. In a subset of survey participants, focus group discussions (FGDs) were also conducted to identify screening barriers.ResultsOverall, 305 WLHIV participated in the survey. Median age was 36 years (interquartile range [IQR]: 28–43), 41% were married, and 38% completed secondary education. Most (90%) had HIV RNA < 1000 copies/mL. Awareness of cervical cancer was high (84%), although only 45% of WLHIV had screened for cervical cancer at the referral hospital and only 13% knew how to prevent high-risk HPV. No participants had received an HPV vaccination. Older age, higher education, and knowledge of the HPV vaccine were associated with higher likelihood of cervical cancer screening (P < 0.05). In FGDs, barriers to utilising the services included user fees, fear of the procedure impacting fertility, age and gender of the provider, and long waiting times.ConclusionDespite integration with HIV services, the utilisation of cervical cancer screening was low among WLHIV and implementation barriers contributed to low utilisation.

Cervical cancer screening utilization and associated factors among women of 30–65 years in Girar Jarsoo district North shoa, Ethiopia, 2021

BackgroundCervical cancer screening is the method of early detection of cervical cancer before occurrence to decrease mortality and morbidity of the women. When women screened at least once in their lifetime for cervical cancer, their risk of cancer could be decreased by 25–36%. Despite this advantage the coverage of cervical cancer screening remains below 2% across country level. Therefore, this study aimed to assess cervical cancer screening utilization and associated factors among women 30–65 years in north shoa Ethiopia. MethodCommunity-based cross-sectional study was conducted using stratified cluster sampling technique among 855 women in March 2021. Data were collected using pretested and semi-structured interviewer administered questionnaire. Adjusted odds ratio with a 95% confidence interval was used to report the association between predictors and the outcome variable. ResultCervical cancer screening utilization was found to be 21.2% (95% CI = 18.5–23.9).Being HIV positive [AOR = 16.49 (95% CI: 9.20–29.54)], knowing someone who had ever been screened for cervical cancer [AOR = 5.46 (95% CI: 2.53–11.79)], having good knowledge about cervical cancer screening [AOR = 3.8 (95% CI: 2.21–6.56)], women found in fourth quintile wealth index [AOR = 3.31 (95% CI: 1.13–9.70)] and having low perceived barriers for cervical cancer screening [AOR = 2.58 (95% CI: 1.43–4.64] were found to be significantly associated with cervical cancer screening utilization. ConclusionThe study revealed the utilization of cervical cancer screening among women 30–65 years is low. Health education program and other multi-disciplinary approaches should be done to increase cervical cancer screening utilization.

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

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.

Awareness and Utilization of Cervical Cancer Screening Among Primary Health Care Workers in Ilesa, Osun State

Cervical cancer is a type of cancer that starts in the cervix which is a cylinder that connects the lower part of a woman’s uterus to her vagina. The study investigated the awareness and utilization of cervical cancer screening services among primary health care workers in Ilesa, Osun state. The study adopted the descriptive cross-sectional research design. The sample size was determined by Taro Yamane, which was 192. Proportionate random sampling technique was used to select female primary healthcare workers. The instrument for data collection was a self-structured questionnaire which was divided into three sections. The instrument was subjected to face and content validity. Cronbach’s Alpha reliability coefficient for the constructs ranged from 0.72 to 0.85. The descriptive statistics was employed to answer the research questions, while Pearson correlation and chi-square analysis were employed to test the hypotheses at 0.05 level of significance. Findings showed that level of awareness and utilisation of cervical cancer screening services was moderate. There was significant relationship between the level of awareness and utilization of cervical screening services among primary health workers (r = .272, p = .000&lt;0.05). Only age (x2 = 25.533, p = .003 &lt; 0.05) and ethnicity (x2 = 18.520, p = .005 &lt; 0.05) were related to level of awareness of cervical screening services while age (x2 = 28.549, p = .000 &lt; 0.05), marital status (x2 = 9.077, p = .011&lt; 0.05), monthly income (x2 = 19.347, p = .000 &lt; 0.05) and educational qualifications (x2 = 51.004, p = .000 &lt; 0.05) were related to level of utilisation of cervical screening services among primary health workers. It was recommended among others that there is need to establish cervical cancer screening education programmes among health care professionals at all levels, especially among nurses.

Abstract PO-252: Impact of COVID-19 public policies on utilization on cervical cancer screening in Puerto Rico during March 15, 2020 to July 31, 2020

Abstract Introduction: Among jurisdictions of the United States, Puerto Rico (PR) has the highest incidence of cervical cancer, and cervical cancer screening (CCS) is below 80%. Public health emergencies have an impact on people's access to health care services. We examined the impact of the public policy implemented by the government of Puerto Rico during the first 5 months of the COVID-19 pandemic in the utilization of CCS for participants of the Government's Public Health Plan. Methodology: This was a retrospective cohort study. A total of 40 government executive orders (issued between March 15 to July 31, 2020) were analyzed according to the level of restrictions they imposed on the population. Three periods with the greatest restrictions were identified: two of them in the government's initial response phase (March 15-30th &amp; March 31st-April 12th) and one in the re-opening phase (July 17-July 31st). We examined the utilization of all modalities of CCS (pap test only and pap + HPV contesting). Rate ratios (RRs) were estimated to compare to CCS rates during periods of 2020 and compared to 2018-2019. Results: In comparison to 2019, CCS decreased during the most restricted period (March 31st-April 12th) of the response phase (RR= 0.19, 95% CI=0.15-0.24 for women 21-29 years; RR= 0.04 95% CI= 0.03-0.05 for women 30-65 years). During the re-opening phase, screening services started to rebound. However, an increase in COVID-19 cases led to another restriction (July 17-July31st), which led to a second phase of decrease in utilization of CCS (RR=0.17, 95% CI=0.13-0.21 for women 21-29 years (RR= 0.09, 95% CI=0.08-0.10 for women 30-65 years). Conclusion: Our results evidence how the public policy implemented as a result of the COVID-19 pandemic in Puerto Rico had a direct impact on the utilization of CCS services in this Hispanic population. Future studies should examine screening patterns and social barriers of service utilization after July 2020 in Puerto Rico. Citation Format: Axel Gierbolini-Bermúdez, Karen Ortiz-Ortiz, Jeslie M Ramos- Cartagena, Kalyani Sonawane, Vivian Colón-Lopez, Ashish Deshmukh, Ana P Ortiz. Impact of COVID-19 public policies on utilization on cervical cancer screening in Puerto Rico during March 15, 2020 to July 31, 2020 [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-252.

Knowledge of Cervical Cancer and Attitudes Towards Its Prevention Among Women Attending Antenatal Clinics in Primary Health Centres in a Niger Delta Capital City

<i>Introduction </i>Cervical cancer is the fourth commonest cause of cancer and cancer-related deaths among women worldwide and commonest gynaecological cancer in Nigeria. This study sort to determine the awareness of cervical cancer, its prevention and determine the attitude and practice of these women towards screening. <i>Materials and methods: </i>This was a descriptive cross-sectional questionnaire-based study to assess the knowledge, attitude and utilisation of cervical cancer screening among pregnant women attending antenatal clinics in primary health centres in Uyo, South-south Nigeria. <i>Results: </i>The mean age of respondents was 34.7±8.9 years. The majority (76.7%) had post-secondary education, were married (69.6%), had 2 or more lifetime sexual partners (>60%) and had been pregnant twice (25%). Most (87.5%) have heard about cervical cancer, mainly from health workers, 116 (44.8%). The top 2 clinical features known were abnormal vaginal bleeding 177 (59.8%) and foul-smelling vaginal discharge 157 (53.0%) while the commonest risk factors mentioned were sex at early age 145 (49.0%) and multiple sexual partners 135 (45.6%). Preventive strategies known include quitting smoking (53.4%), avoiding early sexual intercourse (49%) and avoiding multiple sexual partners (48.3%). The majority, 186 (62.8%) knew about screening measures but less than a quarter knew that all sexually active women should be screened 46 (15.5%), while only 24.7% were aware of free services, 15.2% had ever been screened. The commonest reasons for non-screening were not feeling at risk 68 (27.1%) and being unaware of screening 57 (22.7%) while most had a positive attitude towards screening for cervical cancer. 167 (56.4%). <i>Conclusion: </i>The good knowledge of cervical cancer and attitude towards its screening was not matched by action as only a few had ever been screened despite their high lifetime risk for it. There is therefore the need for further awareness creation on cervical cancer prevention with the aim of increasing their uptake of available screening services in the state.

Perceived neighborhood social cohesion and cervical and breast cancer screening utilization among U.S.-born and immigrant women.

Research suggests that factors beyond the individual level, such as neighborhood-level factors, warrant further investigation in explaining preventive screening utilization disparities. In addition, research shows that immigrant women, especially recent immigrants, are less likely than U.S.-born women to utilize preventive screenings. Our study examined the relationship between perceived neighborhood social cohesion and breast and cervical cancer screening utilization among U.S.-born and immigrant women. Data came from the 2018 National Health Interview Survey (NHIS). The sample for this study included 7801 women ages 21-64 without a hysterectomy. Of them, 1477 (19%) reported being born outside the United States. Logistic regression was used to examine associations of perceived neighborhood social cohesion and sociodemographic factors with the odds of screening by nativity status. Though we found no link between neighborhood social cohesion and Papanicolaou (Pap) test or mammogram utilization, our findings contribute to understanding sociodemographic barriers to and facilitators of preventive screening utilization among immigrant and U.S.-born women. Most importantly, racial/ethnic and socioeconomic disparities in Pap tests and mammogram utilization were evident among immigrant women. The disparities we identified indicate the need to target prevention messages and tailor interventions to address each group's sociodemographic characteristics and needs. Our findings also support the need to expand health insurance so that all women are covered.