DETERMINANTS OF THE UTILIZATION OF CERVICAL CANCER SCREENING SERVICES AMONG FEMALE PUBLIC SERVANTS IN AKURE, ONDO STATE

Abstract

Cervical cancer is the second leading cause of cancer death amongst women in developing countries including Nigeria where there are no effective screening and prompt treatment of precancerous condition of the cervix. Poor knowledge of cervical cancer and the risk factor as well as poor utilization of screening services have been shown to increase mortality and morbidity. Although a lot of research has been conducted on uptake of cervical cancer screening among Nurses and in antenatal clinics, not so much has been documented on utilization of screening services among female public servants. Hence, this study was designed to investigate the determinants of the utilization of cervical cancer screening services among female public servants in Akure, Ondo State. A cross-st!sectional design was adopted for the study and a sample size of 313 consenting women were interviewed using interviewer-administered structured questionnaire. This sought information on demographics, screening practice and willingness to be screened. Knowledge of cervical cancer was assessed using a 65 point scale. Score greater than or equal to 40 was chosen as the cut off in determining good knowledge. Knowledge of cervical cancer risk factors was also assessed using a 50point scale. Score greater than or equal 25 was chosen as the cut off in determining good knowledge. Data were analyzed using descriptive statistics and Chi-square was used to assess the association between categorical variables with level of significance set at 5%. Mean age of respondents was 43.9±6.5 years, 49.2% were in their 4th decade of life. 87.9% were married, 79.2% were Christians. 67.1 % were senior cadre, 79.2% had HND/BS.c, and 70.8% from a monogamous setting.Mean Knowledge score was 45.1±7.038 with 24.9% having good knowledge of cervical cancer. While mean knowledge score for cervical cancer risk factor was 43.7±6.593 with 75.7% having good knowledge. Only 5.4% had ever been screened while 41.2% were willing to be screened. Reasons mentioned for not being screened include little understanding of cervical cancer mentioned by 65%, Not advised or recommended by a doctor (91.2%), thinking of not being at risk (88.2%), do not know where to go for screening (74.7%), believe that screening is for promiscuous women (54.1%). believe that they are healthy (95.3%) and have never heard of cervical cancer screening (67.6%). Majority of respondents who had good knowledge had been screened (p-value= 0.011 ). while others who had not been screened were willing to have a screening test (p-value < 0.05). Also, a respondent whose family members have or has had cervical cancer were more willing to be screened (p-value= 0.048). The poor level of knowledge of cervical cancer and practice of cervical cancer screening among the public servant in Akure underscores the need for the provision of screening services and effective health education to promote preventive practices and inculcate screening culture among the women.