Determinants of cervical cancer screening among women of reproductive age in Bomachoge Chache Sub County, Kisii County

Abstract

Introduction: cervical cancer, the second most prevalent cancer after breast cancer in Kenya but the leading cause of cancer deaths, has had an increasing incidence. Between 2020 and 2021 the prevalence stood at 28.7% with a mortality rate of 50% of the cases diagnosed in 2020. In spite of the possible prevention with early detection through screening, only 4% of reproductive age women in Kisii Sub-County were screened for cervical cancer in the year 2017 against the national target of 75%. Objectives: to examine the determinants of cervical cancer screening among women of reproductive age in Bomachoge Chache Sub County, Kisii County, Kenya. Methods: the study utilized mixed methods applying convergent parallel design. A total of 394 participants from seven health facilities were selected for the study through stratified random sampling. Quantitative data was gathered using questionnaires while qualitative data was obtained via focused group discussions. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 27. Chi-square test was used to determine predictors of cervical cancer screening prevalence and bivariate regression analysis determined the association between determinants of cervical cancer screening and screening practices. A p-value of less than 0.05 (typically ≤ 0.05) was considered statistically significant. Qualitative data was analyzed thematically. Data was presented in tables and pie charts,k and narratives for qualitative data. Results: 206 (57.5%) of the participants were aged between 16 to 19 years, 190 (53%) were married with over 67% of them having at least secondary school education. Notably, although 248(69.2%) of the participants were aware of cervical cancer only 104 (41.9%) were screened. Cervical cancer screening was positively associated with feeling of being at risk of cervical cancer (p <.0001), not being afraid of screening procedures (p <.0001), preference of being attended by a female (p <.0001), a distance of <1km from the nearest screening center (p < .0007). Participants perceived cervical cancer to be caused by witchcraft, curses and sexual immorality. They also had misconceptions such as prayers being a cure to cervical cancer. Further, delay in service delivery was attributed to shortage of health care professionals and inadequate hospital infrastructure. Conclusions: study participants were aware of cervical cancer, risk factors, and warning signs. Screening practices were positively associated with knowledge on cervical cancer, source and monthly income and level of education. Participants perceived that they were not at risk of cervical cancer and believed that witchcraft and sexual immorality were causes of cervical cancer and prayers perceived as the cure.