Factors associated with cervical cancer screening uptake among women in Myanmar: A public health concern
DOI:
https://doi.org/10.62992/5a4bkg02Keywords:
Cervical cancer screening, HPV, Health system, Geographical disparitiesAbstract
Background: Cervical cancer remains a major health challenge globally, with Myanmar bearing one of Southeast Asia's highest incidence and mortality rates, despite a National Cervical Cancer Prevention and Control Program. Prior studies have highlighted barriers to cervical cancer screening among Myanmar women, but limited information exists on specific screening uptake determinants.
Objectives: This study aims to identify the factors associated with cervical cancer screening uptake (CCSU) among women in Myanmar.
Methods: A cross-sectional analytical study, using validated structured questionnaires, was conducted from November 2024 to January 2025 in three townships in Yangon, enrolling 439 women. Descriptive statistics characterized the samples and CCSU status, while inferential statistics and multiple logistic regression identified factors linked to CCSU, reporting Adjusted Odds Ratios (AORs), 95% Confidence Intervals (CIs), and P-values, with significance set at <0.05.
Results: Participants’ mean age was 44.1 (±9.12) years, with Bamar ethnicity predominant (86.56%). Only 10.71% (95% CI: 8.13-13.97%) had undergone cervical cancer screening, mostly via Pap smear (65.96%). In multivariable analysis, living in semi-urban/rural areas was associated with higher screening odds (AOR=2.45, 95% CI: 1.34-5.25). Presence of a chronic illness (AOR=4.25, 95% CI: 2.15-8.41); prior receipt of cervical cancer information (AOR=2.75, 95% CI: 1.28-5.85); Human Papilloma Virus (HPV) vaccination (AOR=2.16, 95% CI: 1.10-4.27); and reported service availability (AOR=2.07, 95% CI: 1.05-4.10) were also significant factors.
Conclusion: CCSU among Myanmar women is critically lower than the global and regional expectations. Key determinants of CCSU include place of residence, chronic illness, health information, HPV vaccination, and accessible services. Integrated screening in chronic disease programs, targeted education, expanded service coverage for equitable access, and comprehensive national strategies are strongly recommended to improve screening rates and reduce cervical cancer burden in Myanmar.
References
WHO. Cervical cancer 2024 [updated 5 March 2024; cited 2024 4 September]. Available from: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49.
Cancer IAfRo. Myanmar Cancer Fact Sheet. In: World Health O, editor.: The Global Cancer Ob-servatory; 2020.
Membrilla-Beltran L, Cardona D, Camara-Roca L, Aparicio-Mota A, Roman P, Rueda-Ruzafa L. Impact of Cervical Cancer on Quality of Life and Sexuality in Female Survivors. Int J Environ Res Public Health. 2023;20(4).
Shah R, Nwankwo C, Kwon Y, Corman SL. Economic and Humanistic Burden of Cervical Can-cer in the United States: Results from a Nationally Representative Survey. Journal of Women's Health. 2020;29(6):799-805.
Thinn MM, Aung S, Aung A, Tun NM. Current Status of Cervical Cancer Prevention and Screening in Myanmar. South Asian Journal of Cancer. 2023;12(01):047-8.
Zhao S, Huang L, Basu P, Domingo EJ, Supakarapongkul W, Ling WY, et al. Cervical cancer burden, status of implementation and challenges of cervical cancer screening in Association of Southeast Asian Nations (ASEAN) countries. Cancer Letters. 2022;525:22-32.
Datchoua Moukam AM, Embolo Owono MS, Kenfack B, Vassilakos P, Petignat P, Sormani J, Schmidt NC. "Cervical cancer screening: awareness is not enough". Understanding barriers to screening among women in West Cameroon-a qualitative study using focus groups. Reprod Health. 2021;18(1):147.
Myint T, Sakphisutthikul C, Thi WM. Factors influencing cervical cancer screening uptake among the women in Maesot, Tak province, Thailand. International Journal of Public Health Asia Pacific. 2023:92-102.
Hsieh FY, Bloch DA, Larsen MD. A simple method of sample size calculation for linear and lo-gistic regression. Statist Med 1998;17(14):1623-34.
Hosmer DW, Lemeshow S. Applied Logistic Regression 2nd Edition Wiley. New York. 2000.
Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logistic regression: John Wiley & Sons; 2013.
Yimer NB, Mohammed MA, Solomon K, Tadese M, Grutzmacher S, Meikena HK, et al. Cervi-cal cancer screening uptake in Sub-Saharan Africa: a systematic review and meta-analysis. Public health. 2021;195:105-11.
Adunlin G, Cyrus JW, Asare M, Sabik LM. Barriers and facilitators to breast and cervical cancer screening among immigrants in the United States. Journal of immigrant and minority health. 2019;21:606-58.
Chowdhury J, Ravi RP. Healthcare accessibility in developing countries: a global healthcare chal-lenge. J Clin Biomed Res. 2022;4(152):2-5.
Ornstein SM, Jenkins RG, Litvin CB, Wessell AM, Nietert PJ. Preventive services delivery in patients with chronic illnesses: parallel opportunities rather than competing obligations. Ann Fam Med. 2013;11(4):344-9.
Sorensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:80.
Sornlorm K, Thi WM. Health literacy and high blood pressure among Myanmar migrant workers in Northeastern Thailand. PLoS One. 2024;19(4):e0302057.
Shwe NK, Laohasiriwong W. Health literacy and hypertension among middle and elderly aged population in Myanmar: A cross-sectional study. International Journal of Public Health Asia Pa-cific. 2022.
Baharum NN, Ariffin F, Isa MR, Tin ST. Health Literacy, Knowledge on Cervical Cancer and Pap Smear and Its Influence on Pre-Marital Malay Muslim Women Attitude towards Pap Smear. Asian Pac J Cancer Prev. 2020;21(7):2021-8.
Thi WM, Sornlorm K. Prevalence and factors associated with limited hypertensive health literacy among Myanmar migrant workers in Northeastern Thailand: Health literacy among Myanmar mi-grant workers. International Journal of Public Health Asia Pacific. 2023:49-60.
Ssentongo P, McCall-Hosenfeld JS, Calo WA, Moss J, Lengerich EJ, Chinchilli VM, Ba DM. Association of human papillomavirus vaccination with cervical cancer screening: A systematic re-view and meta-analysis. Medicine. 2022;101(28).
Mugassa AM, Frumence G. Factors influencing the uptake of cervical cancer screening services in Tanzania: A health system perspective from national and district levels. Nursing Open. 2020;7(1):345-54.
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