Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.

<h4>Background</h4>Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening ser...

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Autores principales:	Melaku Desta, Temesgen Getaneh, Bewuket Yeserah, Yichalem Worku, Tewodros Eshete, Molla Yigzaw Birhanu, Getachew Mullu Kassa, Fentahun Adane, Yordanos Gizachew Yeshitila
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/41bbdc507e4a450d97e6995e1ca2a274
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id	oai:doaj.org-article:41bbdc507e4a450d97e6995e1ca2a274
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Melaku Desta Temesgen Getaneh Bewuket Yeserah Yichalem Worku Tewodros Eshete Molla Yigzaw Birhanu Getachew Mullu Kassa Fentahun Adane Yordanos Gizachew Yeshitila Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.
description	<h4>Background</h4>Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia.<h4>Methods and findings</h4>Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%).<h4>Conclusions</h4>This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.
format	article
author	Melaku Desta Temesgen Getaneh Bewuket Yeserah Yichalem Worku Tewodros Eshete Molla Yigzaw Birhanu Getachew Mullu Kassa Fentahun Adane Yordanos Gizachew Yeshitila
author_facet	Melaku Desta Temesgen Getaneh Bewuket Yeserah Yichalem Worku Tewodros Eshete Molla Yigzaw Birhanu Getachew Mullu Kassa Fentahun Adane Yordanos Gizachew Yeshitila
author_sort	Melaku Desta
title	Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.
title_short	Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.
title_full	Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.
title_fullStr	Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.
title_full_unstemmed	Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.
title_sort	cervical cancer screening utilization and predictors among eligible women in ethiopia: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/41bbdc507e4a450d97e6995e1ca2a274
work_keys_str_mv	AT melakudesta cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis AT temesgengetaneh cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis AT bewuketyeserah cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis AT yichalemworku cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis AT tewodroseshete cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis AT mollayigzawbirhanu cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis AT getachewmullukassa cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis AT fentahunadane cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis AT yordanosgizachewyeshitila cervicalcancerscreeningutilizationandpredictorsamongeligiblewomeninethiopiaasystematicreviewandmetaanalysis
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spelling	oai:doaj.org-article:41bbdc507e4a450d97e6995e1ca2a2742021-12-02T20:04:21ZCervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.1932-620310.1371/journal.pone.0259339https://doaj.org/article/41bbdc507e4a450d97e6995e1ca2a2742021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259339https://doaj.org/toc/1932-6203<h4>Background</h4>Despite a remarkable progress in the reduction of global rate of maternal mortality, cervical cancer has been identified as the leading cause of maternal morbidity and mortality, particularly in sub-Saharan African countries. The uptake of cervical cancer screening service has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. Despite this, there are limited studies in Ethiopia that were conducted to assess the uptake of cervical cancer screening and its predictors, and these studies showed inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled cervical cancer screening utilization and its predictors among eligible women in Ethiopia.<h4>Methods and findings</h4>Databases like PubMed, Web of Science, SCOPUS, CINAHL, Psychinfo, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. All observational studies reporting cervical cancer screening utilization and/ or its predictors in Ethiopia were included. Two authors independently extracted all necessary data using a standardized data extraction format. Quality assessment criteria for prevalence studies were adapted from the Newcastle Ottawa quality assessment scale. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of studies. A random effects model of analysis was used to estimate the pooled prevalence of cervical cancer screening utilization and factors associated with it with the 95% confidence intervals (CIs). From 850 potentially relevant articles, twenty-five studies with a total of 18,067 eligible women were included in this study. The pooled national cervical cancer screening utilization was 14.79% (95% CI: 11.75, 17.83). The highest utilization of cervical cancer screening (18.59%) was observed in Southern Nations Nationalities and Peoples' region (SNNPR), and lowest was in Amhara region (13.62%). The sub-group analysis showed that the pooled cervical cancer screening was highest among HIV positive women (20.71%). This meta-analysis also showed that absence of women's formal education reduces cervical cancer screening utilization by 67% [POR = 0.33, 95% CI: 0.23, 0.46]. Women who had good knowledge towards cervical screening [POR = 3.01, 95%CI: 2.2.6, 4.00], perceived susceptibility to cervical cancer [POR = 4.9, 95% CI: 3.67, 6.54], severity to cervical cancer [POR = 6.57, 95% CI: 3.99, 10.8] and those with a history of sexually transmitted infections (STIs) [POR = 5.39, 95% CI: 1.41, 20.58] were more likely to utilize cervical cancer screening. Additionally, the major barriers of cervical cancer screening utilization were considering oneself as healthy (48.97%) and lack of information on cervical cancer screening (34.34%).<h4>Conclusions</h4>This meta-analysis found that the percentage of cervical cancer screening among eligible women was much lower than the WHO recommendations. Only one in every seven women utilized cervical cancer screening in Ethiopia. There were significant variations in the cervical cancer screening based on geographical regions and characteristics of women. Educational status, knowledge towards cervical cancer screening, perceived susceptibility and severity to cervical cancer and history of STIs significantly increased the uptake of screening practice. Therefore, women empowerment, improving knowledge towards cervical cancer screening, enhancing perceived susceptibility and severity to cancer and identifying previous history of women are essential strategies to improve cervical cancer screening practice.Melaku DestaTemesgen GetanehBewuket YeserahYichalem WorkuTewodros EsheteMolla Yigzaw BirhanuGetachew Mullu KassaFentahun AdaneYordanos Gizachew YeshitilaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259339 (2021)

Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis.

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