UPTAKE OF CERVICAL CANCER SCREENING AMONG WOMEN AGED18-49 YEARS IN MALINDI SUB COUNTY HOSPITAL

Abstract

Cervical cancer is the third most common cancer among women worldwide with an estimated annual incidence of 0.5 million cases and 300,000 deaths. More than 85% of new cases and deaths occur in developing countries. In Kenya, cervical cancer is the leading cause of morbidity and mortality from cancers among women aged 15 to 44 years. Prevention through screening ranks high among the key interventions in combating cervical cancer. However, delays in diagnosis and treatment of cervical cancer related to low screening rates continue to be documented in Kenya. The aim of this study was to identify factors that influence uptake of cervical cancer screening. The specific objectives was to determine cervical screening coverage, assess sociodemographic, knowledge and attitudinal factors that influence cervical screening uptake and determine significant predictors for cervical cancer screening among women of reproductive age attending Malindi sub County hospital. The study targeted women aged between 18 and49 years seeking services at Malindi Sub County hospital. A cross sectional descriptive design that employed a quantitative approach to data collection and analysis were used. A questionnaire was administered to 315 participants providing written informed consent. Data were entered using Microsoft database and analyzed using R statistical package. Frequencies, proportions and means were calculated and chi square test used to test for significant association between screening uptake and explanatory variables. Odds ratio and 95% confidence intervals were used to measure strengths of associations. The result indicated that coverage for cervical cancer screening was low, 17.8% that was below the national target of 70%. It was observed that socio-demographic factors age (p=0.012), level of education (p=0.017), history of sexually transmitted infections diagnosis (p=0.008) and history of oral contraceptive use (p=0.014) significantly influenced cervical screening uptake. Majority of respondents in the study 92.7% had very low knowledge on cervical cancer and screening. Women vi who had screened had positive attitude towards screening (mean 3.69 on a scale of 1 to 5), while those who had never screened had neutral attitude (mean 3.17). Significant attitudinal factors that negatively influenced screening were pain (p=<0.001), cost (p=<0.001), embarrassment (p=<0.001), partners consent (p=0.011) and absence of signs and symptoms (p=0.012) as well as belief that older women were at higher risk than younger for cancer (p=0.028). Significant independent predictors for cervical screening in multivariable logistic regression model were age, level of education, number of times diagnosed with STI as well as cost and embarrassment perceptions. In conclusion, in order to increase its uptake of cervical cancer screening there is need for educational programs that will increase knowledge on cervical cancer and reduce perceived screening barriers.