Appiah Rosemond Serwaa, Boakye Kingsley, Appiah George, Aidoo Antoinette Ama, Acquah-Hagan Gertrude, Singh Bhavana, Appiah Francis, Boateng Daniel
University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
BMC Womens Health. 2025 May 26;25(1):255. doi: 10.1186/s12905-025-03802-3.
Cervical cancer is the fourth most common cancer that affects women worldwide. Cervical cancer is preventable through early detection and treatment of precancerous lesions, yet there is poor uptake among women. In Ghana, there is a paucity of literature on rural-urban variations in cervical cancer screening uptake among women. We, therefore, assessed the rural-urban variations in cervical cancer screening uptake among women in Ghana.
This is a cross-sectional study that utilized data from the women's file of the 2022 Ghana Demographic and Health Survey. The study was limited to 14,973 women who had complete data on the variables of interest. At 95% confidence interval and 5% significance level, a logistic regression model was conducted to ascertain the association between the dependent and independent variables, and results were presented in odds ratio. All analyses were conducted using STATA statistical software version 16.0.
Out of the 14,973 participants, generally, the prevalence of cervical cancer screening uptake was 4.6%. Specifically, 6.3% of urban women and 3.0% of rural women had been screened for cervical cancer. Urban women who were widowed [AOR = 3.58, 95%CI = 2.29-5.60], from Northern region [AOR = 7.22, 95%CI = 3.42-15.25], had given birth to between 2 and 4 children [AOR = 1.54, 95%CI = 1.09-2.17] and had their first sexual intercourse at 10-14 years [AOR = 2.34, 95%CI = 1.20-4.56] had increased odds of cervical cancer screening. Also, urban women belonging to Moslem religion [AOR = 0.58, 95%CI = 0.42-0.80] and those who make joint decisions about their health with their partners [AOR = 0.60, 95%CI = 0.47-0.77] had decreased odds of cervical cancer screening uptake. On the other hand, rural women who had separated/divorced their partners [AOR = 2.21, 95%CI = 1.24-3.95], rural women from North East region [AOR = 2.91, 95%CI = 1.24-6.81] and had their first sexual intercourse at 20-24 years [AOR = 3.24, 95%CI = 1.23-8.55] had increased odds of cervical cancer screening uptake. All the remaining variables (aged [40-49 years], attained tertiary education, belonged to richest wealth quintile, had access to mass media, and enrolled in health insurance scheme) were same (had higher odds of cervical cancer screening uptake) for both rural-urban women in Ghana.
There are rural-urban variations in cervical cancer screening uptake among women in Ghana, in terms of prevalence [with urban women (6.3%) having slightly higher screening uptake than rural women (3.0%)] and determinants. Context-specific interventions aimed at improving cervical cancer screening uptake among women should focus on addressing rural-urban disparities in screening uptake and ensure possible scale-up of cervical cancer screening services, especially for the most vulnerable women.
宫颈癌是全球影响女性的第四大常见癌症。宫颈癌可通过癌前病变的早期检测和治疗来预防，但女性对其接受度较低。在加纳，关于女性宫颈癌筛查接受情况的城乡差异的文献较少。因此，我们评估了加纳女性宫颈癌筛查接受情况的城乡差异。
这是一项横断面研究，利用了2022年加纳人口与健康调查中女性档案的数据。该研究限于14973名在感兴趣变量上有完整数据的女性。在95%置信区间和5%显著性水平下，进行逻辑回归模型以确定自变量和因变量之间的关联，并以比值比呈现结果。所有分析均使用STATA统计软件版本16.0进行。
在14973名参与者中，总体而言，宫颈癌筛查接受率为4.6%。具体而言，6.3%的城市女性和3.0%的农村女性接受过宫颈癌筛查。丧偶的城市女性[AOR = 3.58，95%CI = 2.29 - 5.60]、来自北部地区的城市女性[AOR = 7.22，95%CI = 3.42 - 15.25]、生育2至4个孩子的城市女性[AOR = 1.54，95%CI = 1.09 - 2.17]以及首次性行为发生在10至14岁的城市女性[AOR = 2.34，95%CI = 1.20 - 4.56]进行宫颈癌筛查的几率增加。此外，属于穆斯林宗教的城市女性[AOR = 0.58，95%CI = 0.42 - 0.80]以及与伴侣共同做出健康决策的城市女性[AOR = 0.60，95%CI = 0.47 - 0.77]进行宫颈癌筛查的几率降低。另一方面，与伴侣分居/离婚的农村女性[AOR = 2.21，95%CI = 1.24 - 3.95]、来自东北地区的农村女性[AOR = 2.91，95%CI = 1.24 - 6.81]以及首次性行为发生在20至24岁的农村女性[AOR = 3.24，95%CI = 1.23 - 8.55]进行宫颈癌筛查的几率增加。加纳城乡女性的所有其余变量（年龄[40 - 49岁]、接受过高等教育、属于最富有财富五分位数、可接触大众媒体以及参加了健康保险计划）相同（进行宫颈癌筛查的几率较高）。
加纳女性宫颈癌筛查接受情况存在城乡差异，在患病率方面[城市女性（6.3%）的筛查接受率略高于农村女性（3.0%）]以及决定因素方面。旨在提高女性宫颈癌筛查接受情况的针对具体情况的干预措施应侧重于解决筛查接受方面的城乡差距，并确保宫颈癌筛查服务可能的扩大，特别是针对最脆弱的女性。
