Determinants of Low Uptake of Cervical Cancer Screening Among Sexually Active Women in an Urban Health District in Cameroon

Abstract

Background: Cervical cancer remains a major public health concern in low- and middle-income countries. Screening uptake in Cameroon is far below the World Health Organization’s elimination targets. This study assessed socio-demographic, economic, and informational determinants of low cervical cancer screening uptake among sexually active women in an urban district of Yaoundé. Methods: A cross-sectional study was conducted from September to October 2023 in the Biyem-Assi Health District. A convenience sample of 250 sexually active women aged 25–59 years completed a pre-tested structured questionnaire. Logistic regression was used to identify factors associated with non-participation. Significance was set at p < 0.05. Results: Overall, 89.0% of participants had never been screened. Independent predictors of non-participation were being single (AOR 5.79; 95% CI 3.60–9.45), lack of awareness of screening centers (AOR 5.02; 95% CI 1.24–20.29), no health insurance (AOR 3.91; 95% CI 1.70–8.98), poor knowledge of cervical cancer (AOR 3.16; 95% CI 1.12–8.94), unemployment (AOR 2.16; 95% CI 1.18-4.00), and having ≤1 child (AOR 1.94; 95% CI 1.21-3.12). Conclusion: Cervical cancer screening uptake is critically low in this urban population. The main barriers relate to socioeconomic vulnerability and lack of specific information on where screening services are offered. Improving service visibility, reducing costs, and integrating screening into routine health services may help increase uptake, although further research is required to evaluate feasibility and impact.