Factors affecting the utilisation of cervical cancer screening among women attending health services in the kumasi metropolis of Ghana

[摘要] ENGLISH SUMMARY : Background: Cervical cancer is the second-most frequently diagnosed and the fourth commonest cause of cancer death among women worldwide. Almost 70% of the global burden occurs in areas of lower development. Incidence and mortality rates of cervical cancer among women in Ghana are of the highest in the world. According to the Ghana Health Service,16% of cancer mortality is attributed to cervical cancer. It has also been predicted by the World Health Organization that by the year 2025, 5 000 new cases of cervical cancer and 3 361 cervical cancer deaths will occur annually in Ghana.Purpose: This study aimed to determine factors affecting the utilisation of cervical cancer screening among women attending health services in the Kumasi metropolis of Ghana.Methods: A correlational cross-sectional quantitative study design was used. The target population was women of 18 years and above seeking reproductive health services in the Kumasi metropolis during the study period. A total of 369 participants were selected using a multistage sampling technique. Initially, two of the four hospitals were randomly selected. Subsequently, a systematic sampling technique was used in selecting participants to participate in the study. Data was collected using a researcher-designed questionnaire consisting of 38 closed-ended and open-ended questions. The questionnaire was printed in English and in the Twi language. A pilot study was conducted using 20% of the daily average attendance (200) in the four hospitals in the Kumasi metropolis. Ethical approval to conduct the study was obtained from the Health Research Ethical Committee at Stellenbosch University, as well as consent from the institutions under study. Informed consent was obtained from all the participants. Data was analysed using Statistical Package for Social Science (SPSS) Version 23.0 and findings are presented using descriptive and inferential statistics with 0.05 as the significance threshold.Results: Of the 369 participants, 58% were between the ages of 18 and 30 years, 46.1% were single, and 27.9% and 27.1% had primary and tertiary levels as their highest levels of education respectively. Of the participants, 67.5% were employed, 29.3% had only one child followed by 24.1% who had two children. Of the participants, 75.1% had adequate knowledge on cervical cancer with a mean knowledge score of 7.70±2.13 with range, 2–11 and about 88% had a good perception of cervical cancer and cervical cancer screening. The majority (n=300; 81.3%) had never been screened while 69 (18.7%) had been screened before. Of the 69 (18.7%), 17.3% had been screened only once and 1.4% had been screened twice. The majority of participants were not sure whether cervical screening was painful (46.6%) or expensive (32%), and 41.2% strongly agreed that their partners would not want them to have cervical cancer screening. The study found a significant relationship between socio-demographic characteristics and knowledge, perception and the utilisation of cervical cancer screening respectively. Age significantly affected knowledge level (p=0.022). Marital status significantly affected knowledge (p<0.001) and cervical cancer screening utilisation (p=0.040). Education significantly affected participants' knowledge levels on cervical cancer and cervical screening (p=0.001) and cervical cancer screening utilisation (p=0.003). Work status significantly affected the utilisation of cervical cancer screening by participants (p=0.006).Conclusion: Even though participants had adequate knowledge and positive perception, cervical cancer screening services were not utilised by the participating women. Fear of the screening procedure being painful and expensive may have been part of the reason for the low utilisation of cervical cancer screening. Therefore, all-inclusive health education on the benefits of cervical cancer screening for both women and men should be a priority for stakeholders and all health organisations.

[发布机构] Stellenbosch University