Determinants of cervical cancer screening intention among reproductive age women in Ethiopia: A systematic review and meta-analysis.

Begetayinoral Kussia Lahole, Melkamu Woldamlak, Wondafrash Kussia
Author Information
  1. Begetayinoral Kussia Lahole: Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arbaminch, Ethiopia. ORCID
  2. Melkamu Woldamlak: Department of Radiology Technology, College of Medicine and Health Sciences, Arba Minch University, Arbaminch, Ethiopia.
  3. Wondafrash Kussia: School of Anesthesia, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.

Abstract

INTRODUCTION: Cervical cancer is a leading cause of cancer-related mortality in Ethiopia, despite being preventable. Screening programs remain underutilized despite multiple initiatives. This systematic review and meta-analysis aimed to assess the pooled prevalence of intention to undergo cervical cancer screening and its associated factors among Ethiopian women, addressing a significant gap in national data.
METHODS AND MATERIALS: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, HINARI, Google Scholar, and African Journals online were searched using specific keywords and Medical Subject Headings (MeSH). Studies were assessed using a standardized appraisal format adapted from the Newcastle-Ottawa Scale (NOS). Data extraction and analysis were performed using Microsoft Excel-10 and STATA 17 software, respectively. Heterogeneity was evaluated with the I2 statistic and publication bias was examined using Egger's test. Meta-analysis employed a random-effects model.
RESULT: Out of the 750 articles retrieved, nine were included in this systematic review and meta-analysis. The pooled prevalence of intention to screen for cervical cancer in Ethiopia was 33% (95% CI: 9%-56%). Factors significantly associated with intention to undergo cervical cancer screening included favorable attitude (POR = 2.15, 95% CI: 1.29, 4.26), good knowledge about cervical cancer screening (POR: 3.49; 95% CI: 2.04, 6.93), and direct subjective norm (POR: 1.54; 95% CI: 1.32, 3.54).
CONCLUSION: Based on the findings of this meta-analysis, it was observed that women's intention toward cervical cancer screening was low. Determinants identified included favorable attitude, direct subjective norm, and good knowledge of cervical cancer screening. To enhance women's intention for cervical cancer screening, strategies, and activities should be developed to positively influence perceptions among women and those who influence their decisions. Additionally, efforts to enhance public awareness about cervical cancer and its prevention are crucial.

References

  1. Front Glob Womens Health. 2022 Aug 30;3:939639 [PMID: 36110581]
  2. CA Cancer J Clin. 2021 May;71(3):209-249 [PMID: 33538338]
  3. Front Public Health. 2021 Jan 20;8:552028 [PMID: 33553082]
  4. BMC Womens Health. 2021 Jan 28;21(1):41 [PMID: 33509175]
  5. BMC Cancer. 2018 Mar 16;18(1):298 [PMID: 29548313]
  6. Cancer Inform. 2021 Dec 22;20:11769351211068431 [PMID: 34992337]
  7. Nurs Res. 1999 Jul-Aug;48(4):198-205 [PMID: 10414682]
  8. Gynecol Oncol Res Pract. 2015 Sep 18;2:6 [PMID: 27231566]
  9. PLoS One. 2020 Nov 5;15(11):e0238472 [PMID: 33151928]
  10. BMC Public Health. 2024 Feb 20;24(1):525 [PMID: 38378542]
  11. BMC Public Health. 2012 Dec 19;12:1093 [PMID: 23253445]
  12. PLoS One. 2015 Jun 01;10(6):e0128498 [PMID: 26030869]
  13. Front Public Health. 2023 Feb 27;11:1063694 [PMID: 36923041]
  14. BMC Public Health. 2016 Mar 02;16:213 [PMID: 26935960]
  15. Clin Obstet Gynecol. 2021 Sep 1;64(3):501-518 [PMID: 34120126]
  16. Health Educ Behav. 2015 Oct;42(5):621-6 [PMID: 25712240]
  17. BMC Womens Health. 2018 Feb 27;18(1):43 [PMID: 29482523]
  18. Obstet Gynecol Int. 2020 Feb 07;2020:2805936 [PMID: 32089698]
  19. Prev Med. 2021 Dec;153:106826 [PMID: 34599921]
  20. Biometrics. 1994 Dec;50(4):1088-101 [PMID: 7786990]
  21. BMJ. 2021 Mar 29;372:n71 [PMID: 33782057]
  22. BMC Womens Health. 2017 Jan 31;17(1):9 [PMID: 28137260]
  23. PLoS One. 2012;7(7):e39471 [PMID: 22848355]
  24. J Cancer Epidemiol. 2020 Mar 19;2020:3024578 [PMID: 32256590]
  25. BMC Cancer. 2024 Jan 5;24(1):38 [PMID: 38183018]
  26. BMC Public Health. 2013 Jan 17;13:46 [PMID: 23327453]
  27. BMJ. 1997 Sep 13;315(7109):629-34 [PMID: 9310563]
  28. BMC Womens Health. 2019 Oct 28;19(1):127 [PMID: 31660938]
  29. J Obstet Gynecol Neonatal Nurs. 2008 Sep-Oct;37(5):572-81 [PMID: 18811776]
  30. Community Health Equity Res Policy. 2023 Oct;44(1):65-76 [PMID: 37724032]
  31. J R Stat Soc Ser C Appl Stat. 2020 Nov;69(5):1091-1119 [PMID: 33132447]
  32. Curr Probl Dermatol. 2014;45:1-18 [PMID: 24643174]
  33. Hum Vaccin Immunother. 2021 Feb 1;17(2):434-442 [PMID: 32730107]
  34. Vaccine. 2012 Nov 20;30 Suppl 4:D1-83, vi [PMID: 23510764]
  35. BMC Womens Health. 2022 Nov 21;22(1):462 [PMID: 36404309]
  36. Int J Womens Health. 2020 Dec 17;12:1215-1222 [PMID: 33363414]
  37. Ethiop Med J. 1992 Jan;30(1):13-7 [PMID: 1563358]
  38. BMC Health Serv Res. 2019 Nov 19;19(1):847 [PMID: 31744548]

MeSH Term

Female
Humans
Early Detection of Cancer
Ethiopia
Health Knowledge, Attitudes, Practice
Intention
Mass Screening
Uterine Cervical Neoplasms

Word Cloud

Created with Highcharts 10.0.0cancercervicalscreeningintentionmeta-analysissystematicreviewusing95%CI:amongwomenincluded1Ethiopiadespitepooledprevalenceundergoassociatedfavorableattitude2goodknowledgePOR:3directsubjectivenorm54women'sDeterminantsenhanceinfluenceINTRODUCTION:Cervicalleadingcausecancer-relatedmortalitypreventableScreeningprogramsremainunderutilizedmultipleinitiativesaimedassessfactorsEthiopianaddressingsignificantgapnationaldataMETHODSANDMATERIALS:followedPreferredReportingItemsSystematicReviewsMeta-AnalysesPRISMAguidelinesDatabasesPubMedEMBASECINAHLWebScienceCochraneLibraryHINARIGoogleScholarAfricanJournalsonlinesearchedspecifickeywordsMedicalSubjectHeadingsMeSHStudiesassessedstandardizedappraisalformatadaptedNewcastle-OttawaScaleNOSDataextractionanalysisperformedMicrosoftExcel-10STATA17softwarerespectivelyHeterogeneityevaluatedI2statisticpublicationbiasexaminedEgger'stestMeta-analysisemployedrandom-effectsmodelRESULT:750articlesretrievedninescreen33%9%-56%FactorssignificantlyPOR=1529426490469332CONCLUSION:BasedfindingsobservedtowardlowidentifiedstrategiesactivitiesdevelopedpositivelyperceptionsdecisionsAdditionallyeffortspublicawarenesspreventioncrucialreproductiveageEthiopia:

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