Is there an association between intimate partner violence and the prevalence of cervical cancer screening in Jordan?

Abstract

Background Major health inequalities exist surrounding the utilisation of cervical cancer screening services globally. Jordan, a low- and middle-income country, has poor screening rates (15.8%), with barriers to accessing services, including lack of education. Emerging studies demonstrate that intimate partner violence (IPV) impacts reproductive health decisions. As a large proportion of Jordanian women have reported experiencing IPV, this study examines the association between IPV and cervical cancer screening in Jordan, the first of its kind using national-level data. Methods Using Jordan’s Demographic Health Survey 2017–18, cervical cancer screening awareness and self-reported screening were estimated in participants who answered questions on IPV (n = 6679). After applying sample weights, Heckman’s two-stage probit model determined the association of awareness and utilisation of cervical cancer screening with experience of IPV, adjusting for the socio-economic factors. Results Of the women with privacy to answer the IPV module, 180 (3.4%) were found to be victims of sexual violence, 691 of physical violence (12.6%) and 935 (16.2%) of emotional violence. Women subjected to sexual violence were less likely to admit to having awareness of a Pap smear test; however, this did not impact screening rates. Victims of emotional violence were more likely to be screened than non-victims. No association between physical violence and cervical cancer screening was found. Conclusions A significant association between cervical screening awareness and IPV demonstrates that cancer screening policies must consider IPV among women to improve screening awareness. The paper further sheds light on the paradoxical association between emotional violence and screening. It is acknowledged this situation may be far worse than reported, as women without autonomy were unlikely to answer IPV questions that may endanger them—targeted surveys on cervical cancer screening warrant further investigation.

Review Of Cross-Sectional Study About Knowledge And Attitude Towards Cervical Cancer Screening Among Female Refugees: Jordan

“…The acceptance of using condom by spouses associated with knowledge and attitudes of CCS [28]. The study did not disclose the relevancy between CC screening rates and exposure for sexual violence in despite of the awareness of the Pap smear test [29]. Moreover, a positive influence was shown on the attitudes of women towards CCS with the implementation of community-based health education programmes [26], [29], [30], [31], and [32].…”

“…Further review was obtained of the full texts of 50 citations and 41 studies were not included owing to the reasons mentioned in the above Figure 4. Therefore, this scoping review included a total of 9 articles [26], [27], [28], [29], [30], [31], [32], [33], and [34]. All studies were published between 2003 and 2023, out of which 50% of studies were within the last five years.…”

“…Moreover, the studies showed varied symptoms and signs of CC. However, the study demonstrated that the female refugees were aware about the symptoms of CC and knew that causes of CC is considered as an abnormal cell growth even though all women in the study heard about CC [29]. Another study determined that the participants showed poor knowledge about symptoms [28].…”

“…For instance, CCS is a cancer that can be prevented by detecting abnormalities or cancers that could result in cancer. In the study of patients, the lowest level of knowledge regarding CCS was determined [29]. Education was the only factor associated with the CCS knowledge level based on the studies of gynaecological outpatients [26], [27], and [34].…”

“…The number of women with 39.3% had been willing to have the Pap smear test [26]. Adequate knowledge of CCS is included among women in some studies [27] and [29]. For instance, CCS is a cancer that can be prevented by detecting abnormalities or cancers that could result in cancer.…”