Factors Affecting the Acceptability of Cervical Cancer Screening Among Young Women (18-35 Years) in the Greater Accra Region, Ghana.

Abstract

Background: About 85% of all Cervical Cancer (CxCA) cases occur in low- and middle income countries (LMICs). Prophylactic HPV vaccination can prevent the disease, but when it occurs, early detection through screening significantly reduces morbidity and mortality. Increasing screening and vaccination uptake is key to lowering CxCA incidence in these regions. Aim: To identify the factors affecting the acceptability and uptake of cervical cancer screening and HPV vaccination among young women (18-35 years) in the Greater Accra region, Ghana. Methods: This cross-sectional study used a mixed-methods approach. Women 18-35 years old living in the Greater Accra Region were recruited for this study. Quantitative questionnaires were used to collect data on acceptability and uptake of vaccination and screening for early disease. Crude associations were tested using chi-squared and Fisher's exact tests. Ordinary and Firth logistic regression models were fitted to determine factors associated with the acceptability and uptake of screening and vaccination. Qualitative data were transcribed verbatim into Microsoft Word. Analysis involved repeated reading and identification of themes, their interrelationships and their contextual interpretations. The quantitative and qualitative data were triangulated using the pillar approach. Results: The acceptability of screening for early cervical changes was 64.4% whilst the uptake was 4.7%. HPV vaccination acceptability was 56.5% whilst the uptake was 1.39%. Awareness was associated with uptake of both screening and vaccination. Knowledge of CxCA and access to a screening and vaccination facility were associated with the acceptability of both screening and vaccination. Awareness of vaccination was associated with 4.32 [AOR: 5.09; 95% C.I: 1.29,21.0; p-value:0.02] increased odds of screening and 3.69 [95% C.I: 1.70,8.02; p value:0.001] increased odds of vaccination. Conclusion: Being in a union and knowledge of CxCA were associated with screening. Awareness of vaccination was a determinant for both screening and vaccination uptake. This emphasises the need to increase education on CxCA Screening and HPV Vaccination particularly in local languages.