Seifu Beminate Lemma, Asnake Angwach Abrham, Belayneh Teshale, Hailemariam Tesfahun
Department of Public Health, College of Medicine and Health Sciences, Samara University, Afar, Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
BMC Cancer. 2025 Jul 1;25(1):1067. doi: 10.1186/s12885-025-14474-5.
Though studies reported factors determining cervical cancer screening, investigating community-level determinants was limited and not conclusive. This study included both individual- and community-level indicators to investigate factors affecting cervical cancer screening nationwide in Kenyan reproductive-age women.
The 2022 Kenyan Demography and Health Survey data was used for the study. A total of 16,716 reproductive-age women were included in the analysis. A multilevel analysis using generalized linear mixed models with the log-binomial function was applied to examine the association between individual- and community-level factors with cervical cancer screening. The goodness of a fit model was identified by using deviance, and the model with the lowest deviance was considered as the best-fitted model. Adjusted odds ratio (AOR) with its 95% confidence interval (CI) at p-value < 0.05 was used to declare significantly associated factors with women's cervical cancer screening.
The pooled prevalence of cervical cancer screening in Kenya was 7.40% (95% CI: 7.02%, 7.78%). Women's age, marital status, educational status, wealth index, employment status, media exposure, parity, contraceptive use, visited health facility last 12 months, self-reported sexually transmitted disease, and geographical zone were significantly associated with cervical cancer screening.
Policies should give emphasis to community-based education, health insurance coverage to overcome the financial burden of the community, create opportunities for women`s employment, strengthen media exposure to educate women, and increase the coverage of contraceptive use. Moreover, infrastructure accessibility and awareness creation on the benefits of facility visits and medical checkups could improve cervical cancer screening in Kenya.
尽管有研究报告了决定宫颈癌筛查的因素，但对社区层面决定因素的调查有限且尚无定论。本研究纳入了个体层面和社区层面的指标，以调查影响肯尼亚育龄妇女全国宫颈癌筛查的因素。
本研究使用了2022年肯尼亚人口与健康调查数据。共有16716名育龄妇女纳入分析。采用广义线性混合模型结合对数二项式函数进行多水平分析，以检验个体层面和社区层面因素与宫颈癌筛查之间的关联。通过偏差来确定拟合模型的优度，偏差最低的模型被视为最佳拟合模型。在p值<0.05时，使用调整后的优势比（AOR）及其95%置信区间（CI）来确定与女性宫颈癌筛查显著相关的因素。
肯尼亚宫颈癌筛查的总体患病率为7.40%（95%CI：7.02%，7.78%）。女性的年龄、婚姻状况、教育程度、财富指数、就业状况、媒体接触情况、生育次数、避孕措施使用情况、过去12个月内就诊的医疗机构、自我报告的性传播疾病以及地理区域与宫颈癌筛查显著相关。
政策应强调社区教育、医疗保险覆盖以减轻社区的经济负担、为女性创造就业机会、加强媒体宣传以教育女性以及提高避孕措施的使用率。此外，改善基础设施可达性以及提高对就诊和体检益处的认识，可能会改善肯尼亚的宫颈癌筛查情况。
