Determinants of cervical cancer screening utilization among reproductive age women in Bench Sheko and Sheka Zone, Southwest Ethiopia, 2024: Multi-Center Facility-Based Case-Control Study

Abstract

Background: Cervical cancer is the fourth most common cancer among women globally, but the second in Ethiopia, where cervical cancer screening utilization remains low. Reports in Bench Sheko and Sheka Zones revealed that screening rates have not met national targets, highlighting the need to identify factors influencing screening rates. Objective: To assess the determinants of cervical cancer screening utilization among reproductive-age women in Bench Sheko and Sheka Zones, Southwest Ethiopia, 2024. Methods: An unmatched case-control study was conducted in the Bench Sheko and Sheka zones, involving 288 reproductive-age women from October 15 to December 30, 2024. Cases were selected consecutively, while controls were selected through systematic random sampling after the first participant was selected by the lottery method. Data were collected using Kobo Toolbox on Android devices and analyzed with SPSS (version 26). Variables with p<0.25 in bivariable analysis were included in multivariable logistic regression. Statistical significance was assessed using adjusted odds ratios (AOR) (95% confidence interval (CI)), with p< 0.05 considered significant. Finally, results were displayed through text, tables, and graphs. Results: A total of 284 participants were included (94 cases and 190 controls), achieving a 98.6% response rate. The mean age was 31.43 years (± 6.28) for cases and 32.85 years (± 5.53) for controls. Urban residency (AOR: 2.11, 95%CI: 1.13,3.94) secondary education (AOR: 2.69,95% CI:1.06,6.85), receiving recommendations from health care workers (AOR: 3.64, 95% CI: 1.95,6.79), waiting for two or fewer hours in health facilities (AOR: 4.95, 95% CI: 2.12,11.57), membership in women development army (AOR: 2.96, 95% CI: 1.53,5.74), and having good knowledge of cervical cancer and cervical cancer screening (AOR:1.85, 95% CI: 1.01,3.41) were found to be determinants of cervical cancer screening utilization. Conclusion and recommendation: The findings revealed that urban residency, secondary education, health care workers' recommendations, waiting time in health facilities, membership in the women's development army, and good knowledge are determinants of cervical cancer screening utilization. Attention is needed for rural women by promoting the Women’s Development Army, enhancing healthcare systems to reduce waiting times, and raising awareness to boost cervical cancer screening utilization rates effectively.