Ach’Sah Gubena
Research Mentor(s): Abram Wagner
Mentor Department: Epidemiology
Authors:
Session: Session 2 (10:00am – 10:50am)
Presentation Type: Poster 85
Abstract
Cervical cancer ranks as the fourth most prevalent cancer among women, with 90% of the new cases and deaths occur in low- and middle-income countries. China is among the countries with the most significant disease burden, accounting for 18% of cases and 17% of mortality. This high burden is partly attributed to limited access to cervical cancer screening services. The study aims to explore the barriers and facilitators of cervical cancer screening while examining the gap between willingness to screen and actual screening behavior. An explanatory sequential mixed-methods design was employed, beginning with a cross-sectional survey study followed by semi-structured one-on-one interviews. The Health Belief Model was used to guide the design of the questionnaire and the interview guide. In the quantitative phase, a multivariable logistic regression model was used to assess the association between cervical cancer screening history and factors such as marital status, sexual behavior, and other demographic variables. Deductive and inductive analytical methods were employed to analyze the interview transcripts. A total of 746 participants were recruited through a panel survey and social media, with 20 participants selected for interviews based on their voluntary participation and screening patterns. The quantitative analysis revealed significant associations between cervical cancer screening history and factors such as marital status, sexual activity, age, and HPV vaccination history. Interviews identified four key perceived barriers: insufficient knowledge, negative experiences with healthcare workers, social norms, and financial barriers related to insurance and cost. Social norms were further divided into two sub-themes: inadequate sexual education and marital status used as a proxy for sexual activity. Enhancing cervical cancer screening knowledge through public education campaigns and providing targeted operational training for healthcare workers are actionable steps to increase screening rates. Additionally, comprehensive sexual education for adolescents, eliminating stigma surrounding sexual activity, and addressing misconceptions about the sexually transmitted nature of HPV are crucial for promoting cervical cancer screening.
