Factors affecting cervical cancer screening among women of child bearing age, attending Intermediate Hospital Oshakati (IHO), Oshana region, Namibia: A case-control study

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Date
2018
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Publisher
University of Namibia
Abstract
Cervical cancer is the second most prevalent cancer among women after breast cancer, in Namibia. Human Papilloma Virus is the significant cause of cervical cancer prevalence worldwide with an estimation of 99.7%. The World Health Organisation (WHO) predict that Cervical cancer will kill >443,000 women worldwide every year by 2030, nearly 90% of them in Sub-Saharan Africa. Nevertheless, cervical cancer is potentially preventable through HPV vaccination, early diagnosis of pre-invasive cancer cells and early diagnosis of proven cases of cervical cancer neoplasia. Cervical cancer screening and early treatment of pre-invasive cervical cancer remain the most effective ways to reduce cervical cancer mortalities. A significant number of women in Oshana region do not utilize the cervical cancer screening services despite a well-established free cervical cancer screening programme in the region .This study examined factors associated with cervical cancer screening and determined associations between cervical cancer screening and identified factors. An unmatched 1:1 case control study was conducted on 207 cases and 207 controls. A case was defined as any woman aged 15-49 years, seeking services at Intermediate Hospital Oshakati ante-natal clinic during the study period, and never had cervical cancer screening in her life time. A control was any woman aged 15-49 years, seeking services at Intermediate Hospital Oshakati ante-natal clinic during the study period, had cervical cancer screening in her life time. Data were collected using a self-administered structured questionnaire between September and October 2017. Data were analysed with Epi-info 7.2. Bivariate analysis was conducted to determine the odds ratio at 95% CI. Factors which were significant at p-value <0.05 were retained in the multiple logistic regression analysis model. Cases were significantly younger than controls (AOR= 3.10, 95% CI: 1.41 - 9.23, P-value=0.001). Increased parity was found to be an important determinant for being screened for cervical cancer (AOR= 4.50, 95% CI: 2.25-9.02, P-v= 0.001). The multivariate analysis found that, fear screening will reveal cervical cancer (AOR= 0.54, 95% CI:0.34 - 0.85, P-v= 0.008), fear of pain from the procedure (AOR= 0.23,95% CI:0.15 - 0.64 P-v= 0.001), lack of signs and symptoms of the disease (AOR= 0.41, 95% CI:0.26 - 0.64, P-v= 0.001) and low perceived risk of the disease (AOR= 0.54, 95% CI: 0.34 - 0.85, P-v= 0.007) were most significantly associated with cervical cancer screening. Identified factors may serve as targets for cervical cancer screening health education interventions by health care health workers. There is need to develop targeted interventions which will promote utilization of cervical cancer screening inclusive of young women.
Description
A thesis submitted in partial fulfillment of the requirements for the Degree of Master of Science in Applied Field Epidemiology
Keywords
Cervical cancer, Child bearing age
Citation