Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
School of Nursing & Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
BMC Health Serv Res. 2024 Apr 3;24(1):423. doi: 10.1186/s12913-024-10881-9.
Cervical cancer is the second dominant type of cancer among Ivorian women with an estimated age-standardised incidence and mortality rate of 31.2 cases and 22.8 deaths per 100,000 women in 2020, respectively. The Ivorian government through its Ministry of Health implemented the National Cancer Control Programme (NCCP) in 2003 with the aim of improving the prevention, early detection and treatment of cancers in Côte d'Ivoire. Yet, there is a low uptake of CCS (1.2%). Thus, making CCS uptake an important public health concern in the country. Understanding of the extent to which reproductive factors predict CCS uptake is limited in literature. This study aimed to investigate reproductive factors as a predictor of women's uptake of CCS in Côte d'Ivoire.
Data from the 2021 Côte d'Ivoire Demographic and Health Survey. A sample of 9,078 women aged 25-49 years were analyzed. The outcome variable was CCS uptake while other variables considered included age at menarche, history of STI, sexual debut, parity, age, educational level, wealth index, health insurance, place of residence, and media exposure. A multivariable logistic regression model was fitted to examine the association between the outcome of interest and predictors at 95% confidence interval.
Approximately, 7.52% of women aged 25-49 years had ever undergone testing for cervical cancer by a healthcare provider. Early menarche was associated with lower odds of CCS uptake [AOR = 0.78; CI = 0.65-0.95]. Compared to those who had no STI, women with a history of STI were more likely to screen for cervical cancer [AOR = 2.63; CI = 2.02-3.42]. Increasing age, higher educational attainment, having health insurance, and being exposed to media were significantly associated with CCS uptake.
In Cote d'Ivoire, age at menarche and STI history constitute reproductive factors that were significantly associated with women's uptake of CCS. It is imperative for public policy to focus on increasing CCS in these higher-risk women (i.e., women who experienced early menarche, women with early sexual debut and higher parity) through increased sensitization on cervical cancer risk factors.
宫颈癌是科特迪瓦女性中第二大常见癌症类型，2020 年，科特迪瓦的年龄标准化发病率和死亡率分别估计为每 10 万名女性 31.2 例和 22.8 例死亡。科特迪瓦政府于 2003 年通过其卫生部实施了国家癌症控制计划（NCCP），旨在改善科特迪瓦癌症的预防、早期发现和治疗。然而，科特迪瓦的 CCS 普及率（1.2%）仍然较低。因此，提高 CCS 的普及率是该国一个重要的公共卫生关注点。目前，文献中对生殖因素预测 CCS 普及率的程度的了解有限。本研究旨在调查生殖因素对科特迪瓦女性 CCS 普及率的预测作用。
本研究数据来自 2021 年科特迪瓦人口与健康调查。对 9078 名年龄在 25-49 岁的妇女进行了分析。因变量为 CCS 的普及率，同时考虑的其他变量包括初潮年龄、性传播感染史、首次性行为、生育史、年龄、教育水平、财富指数、医疗保险、居住地和媒体接触。使用多变量逻辑回归模型在 95%置信区间内检验感兴趣的结果与预测因素之间的关联。
25-49 岁的妇女中，约有 7.52%的人曾由医疗保健提供者进行过宫颈癌检测。初潮早与 CCS 普及率降低有关[比值比（AOR）=0.78；置信区间（CI）=0.65-0.95]。与没有性传播感染史的妇女相比，有性传播感染史的妇女更有可能接受宫颈癌筛查[AOR=2.63；CI=2.02-3.42]。年龄增加、教育程度提高、有医疗保险和接触媒体与 CCS 的普及率显著相关。
在科特迪瓦，初潮年龄和性传播感染史是与妇女接受 CCS 普及率显著相关的生殖因素。通过提高对宫颈癌危险因素的认识，针对这些高风险妇女（即经历过早初潮、早期性行为和更高生育史的妇女），制定公共政策，重点提高 CCS 的普及率至关重要。
