Cervical Cancer Screening Utilization and Determinant Factors among Adult Women in Jimma Town (2025): A Mixed-Methods Study

Abstract

Introduction: Cervical cancer remains a leading cause of morbidity and mortality in Ethiopia due to low screening utilization. While screening methods exist, factors influencing low uptake among community women require further local assessment. This study aimed to assess the level of cervical cancer screening utilization and identify determinant factors affecting it among adult women in Jimma Town. Methods: A community-based, cross-sectional mixed-methods study was conducted from Feb 14 to August 18, 2025. For the quantitative component, a sample of 384 women was selected using a multi-stage sampling procedure, involving systematic randomization across initial stages (such as kebele selection) to ensure sample representativeness, and data were collected via a pre tested, interviewer- administered questionnaire. Data analysis involved descriptive statistics and multivariable logistic regression to identify independent factors influencing screening utilization using SPSS 26. For the qualitative component, 12 key informants were selected using purposive sampling, and data were gathered through semi-structured interviews, which were then analysed thematically. Results: Cervical cancer screening utilization was 17.41% (95% CI: 13.7–21.6%). Significant determinants of screening utilization included being 40–60 years of age (AOR = 2.62; 95% CI: 1.11–6.17). Women with a tertiary education level were more likely to be screened (AOR = 5.99; 95% CI: 1.15–31.40). Those with a gravidity of four or more also showed higher utilization (AOR = 3.03; 95% CI: 1.23–7.46). A history of sexually transmitted infections was another significant factor (AOR = 2.01; 95% CI: 1.06–3.84). Additionally, women with good knowledge of cervical cancer had increased likelihood of screening (AOR = 2.07; 95% CI: 1.09–3.92). Qualitative findings indicated that recent contact with the health system such as during pregnancy or STI care encouraged screening uptake. However, fear, stigma, and health-system limitations, including staff and supply shortages, continued to hinder utilization. Conclusion and Recommendations: Cervical cancer screening utilization in Jimma Town is low, falling short of national and global targets. Screening is more common among older women, those with higher education, multiple pregnancies, STI history, and better knowledge. Barriers include low awareness, fear, and stigma, while motivation stems from health advice and fear of illness. To improve uptake, we recommend focused community education, mobile screening units, and culturally sensitive approaches. These steps can boost participation and ease the local burden of cervical cancer.