Determinants of acceptability of cervical cancer screening among women of reproductive age in the Kalamu 1 Health Zone, Kinshasa, Democratic Republic of the Congo

Abstract

Introduction Cervical cancer is primarily associated with persistent infections by specific oncogenic human papillomaviruses (HPV), which can cause cellular changes leading to precancerous and cancerous conditions. Screening is crucial for detecting precancerous lesions, enabling early interventions to prevent cancer progression. Purpose This study aims to identify the determinants influencing the acceptability of cervical cancer screening among women of reproductive age (18-49) in the Kalamu 1 Health Zone, Kinshasa. Methods A quantitative, cross-sectional, descriptive study was conducted using the Fisher exact formula, a population of over 10,000 in the Kalamu 1 Health Zone. A total of 415 women were surveyed between August 20 and September 4, 2019, using a semi-structured questionnaire. Logistic regression analysis was employed to assess the relationship between various factors and screening acceptability. Results The average age of respondents was 28 ± 7 years. Logistic regression identified key determinants affecting screening acceptability. A low level of education was significantly correlated with reduced acceptability (odds ratio: 8.91; 95% CI [1.46-35.27]; p = 0.01), indicating that less-educated women are about nine times less likely to accept screening. Women unaware of cervical cancer were also significantly less likely to participate (odds ratio: 19.30; 95% CI [9.13-35.20]; p = 0.00), highlighting a strong link between lack of knowledge and refusal. Additionally, the distance from home to the screening center emerged as a major barrier (odds ratio: 22.87; 95% CI [8.10-60.47]; p = 0.00), with those living farther away nearly 23 times less likely to accept screening. These results underscore the need for enhanced awareness programs and improved access to screening services, especially in remote areas. Conclusion Targeted public health interventions are essential for improving cervical cancer screening uptake. Educational programs must increase awareness about cervical cancer and the importance of early screening, particularly among women with limited formal education. Expanding the geographic accessibility of screening services could address significant barriers, enhancing participation and contributing to better prevention and early detection of cervical cancer within the community.

Keywords

• Cervical cancer awareness
• screening barriers
• health service access
• screening acceptability
• reproductive health