Impact of knowledge and attitude on the utilization rate of cervical cancer screening tests among Ethiopian women: A systematic review and meta-analysis

Abstract

Introduction Cervical cancer is a major public health problem, particularly in resource-limited settings. The use of vaccination and screening tests has reduced the burden of cervical cancer in developed countries. However, the situation is quite the reverse in developing countries, including Ethiopia. Hence, this study aimed to estimate the pooled impact of knowledge and attitude on the prevalence of cervical cancer screening service utilization rates among Ethiopian women. Methods Studies that examined cervical cancer screening service utilization among women in Ethiopia were searched from five international databases. Cochran’s Q chi-square and the I-squared test statistics were used to check the presence of heterogeneity among the included studies. The funnel plot and Egger’s regression tests were also used to assess the presence of publication bias. A weighted DerSimonian and Laird random-effects model was employed. Subgroup analysis was performed by the study population concerning the prevalence of cervical cancer screening service utilization rates. Sensitivity analysis was also conducted to assess the effect of a single study on the pooled estimates. Data analysis was performed using STATA™ Version 14 software. Results A total of 44 studies with 28,186 study participants were included. The estimated pooled prevalence of cervical cancer screening service utilization was 8.11% (95% CI: 7.26, 8.97). After adjustment for publication bias with the trim and fill analysis, the estimated prevalence rate appeared to be 5.47% (95% CI: 4.66, 6.28). The prevalence of cervical cancer screening service utilization was higher among HIV-positive women, 16.85%, and in studies conducted among health care workers, 10.24%, than the general population. The pooled effect of knowledge on the utilization of cervical cancer screening tests among Ethiopian women was statistically significant (AOR = 3.20, 95% CI: 1.63, 6.31). Similarly, the pooled estimated odds of utilizing cervical cancer screening tests were 6.1 times higher (AOR = 6.09, 95% CI: 1.09, 34.36) among women who had a favorable attitude towards the screening tests. Conclusion Knowledge and attitude had a significant impact on the prevalence of cervical cancer screening test utilization rates among women in Ethiopia. However, the prevalence of cervical cancer screening service utilization among Ethiopian women is very low. Hence, large-scale awareness programs and situation-based strategies need to be designed to increase the uptake of cervical cancer screening services in the country.

Determining Behavioral to Uptake and Its Predictors toward Cervical Cancer Screening among Women: A Case-Control Multistage Study

“…The pooled odds of knowledge score were 1.61 times greater for women who screened of cervical cancer than for those who do not conduct screening test. Similarly, with systematic review and meta-analysis among Ethiopian women with a favorable knowledge toward cervical cancer screening were 3.2 times more likely to have a test than those with a poor knowledge (Kassie et al, 2020). However, several studies conducted in various parts of Indonesia have revealed that the majority of women do not only have poor knowledge about cervical cancer screening tests, but also have lack of awareness about the illness itself (Endarti et al, 2018;Jaspers et al, 2011).…”

Histopathological profile of cervical punch biopsies and risk factors associated with high-grade cervical precancerous lesions and cancer in northwest Ethiopia

“…More than half of the participants in our study also reported that they were unaware of cervical cancer at all. Previous studies also stated that most Ethiopian women had poor knowledge about cervical cancer [ 35 , 36 ].…”

“…Persistent infection with oncogenic or high-risk Human papillomaviruses (HR-HPV; e.g., HPV16, 18,31,33,35,39,45,51,52,56,58,59 and 68) is the main cause of cervical cancer [8]. However, a recent study revealed that nearly 5% of cervical cancer cases were not HPV-associated, which is a unique biological entity with a different molecular profile when compared with HPV-associated cancers [2].…”

Knowledge, awareness, attitudes and screening practices towards breast and cervical cancer among women in Nepal: a scoping review

“…Our results regarding BC and CC screening behaviours align with findings from other studies. A meta-analysis conducted by Kassie et al (2020) estimated that the uptake of CCS among women in Ethiopia was 8% and knowledge of CC was significantly associated with the utilisation of CCS. A review of the uptake of BC screening in low-resource countries found that utilisation of BC screening in Asian countries was 19% (Mahumud et al 2020).…”