Disparities in cervical cancer screening participation in Iran: a cross-sectional analysis of the 2016 nationwide STEPS survey

Abstract

Background One of the most important concerns in every healthcare system is the elimination of disparities in health service utilization and achievement of health equity. This study aimed to investigate the disparities in cervical cancer screening participation in Iran. Methods A cross-sectional study was conducted using data from the National Non-Communicable Risk Factors Survey in 2016 (STEPs 2016). Data on cervical cancer screening in addition to demographic and socio-economic factors from 15,975 women aged 18 and above were analyzed. The distribution of surveyed women with regard to cervical cancer screening practice was described. Chi square and logistic regression were used to assess the association of demographic and socio-economic factors with cervical cancer screening participation. Results Overall, 52.1% of women aged 30–59 years, had undergone cervical cancer screening at least once in their lifetime. Participation rate in cervical cancer screening programs varied between provinces; ranging from 7.6% in Sistan and Baluchestan to 61.2% in Isfahan. Single marital status, illiteracy, being employed, and having no insurance coverage were associated with lower participation. Age and area of residence were insignificant predictors for participating in cervical cancer screening program. Analysis of the cervical cancer uptake rates across the socio-economic levels revealed that the service is less utilised by high income groups. Conclusions Participation in cervical cancer screening program in Iran is not optimal and could be improved. With regard to the distribution of cervical cancer screening practice, social and geographical disparities indicate the need for further research and more comprehensive strategies in order to reduce them.

Improve the cervical cancer prevention behaviors through mobile-based educational intervention based on I-CHANGE model: study protocol for a randomized controlled trial

“…This study aims to assess the effect of the I-change model on choosing the cervical cancer prevention behaviors in Iranian women. Cervical cancer is a major public health disease in the north of Iran [ 37 ]. Even with free screening nationwide and a cervical cancer screening registry, more than 40% of eligible women do not adhere to cancer screening guidelines [ 37 ].…”

“…Cervical cancer is a major public health disease in the north of Iran [ 37 ]. Even with free screening nationwide and a cervical cancer screening registry, more than 40% of eligible women do not adhere to cancer screening guidelines [ 37 ].…”

“…Many policy interventions have been performed to improve cervical cancer prevention behaviors [ 13 , 16 , 37 , 38 , 39 , 40 ]; however, they were not sustained for a long time. These experiences indicate that designing appropriate interventions for promoting cervical cancer prevention behaviors and encouragement to perform a Pap smear test are necessary [ 41 , 42 , 43 ].…”

Improving intervention design to promote cervical cancer screening among hard-to-reach women: assessing beliefs and predicting individual attendance probabilities in Bogotá, Colombia

“…However, little has been discussed about the differences in beliefs among women suffering different levels of poverty. Targeting marginalized communities with tailored interventions could improve screening uptake [ 2 , 8 , 67 ]. Therefore, our results suggest the need to develop new information material for lower income patients in Bogotá.…”

“…Although the overall Age Standardized Incidence Rate (ASIR), per 100,000 women is 13.1, it ranges from 6.0 in Australia and New Zealand to 40.1 in Eastern Africa [ 1 ]. In fact, both incidence and mortality rates are associated with poverty and limited health education [ 2 – 4 ]. In 2018, around 84% of the cases and 88% of cervical cancer deaths occurred in poorly-resourced countries [ 1 ].…”