Factors Associated With Cervical Cancer Awareness Among Women of Reproductive Age in the Democratic Republic of the Congo: Evidence From a Nationwide DHS Analysis

Abstract

BACKGROUND: Cervical cancer (CC) is a major public health concern, ranked as the fourth leading cause of cancer. Evidence shows that CC is preventable if detected and treated at the early stages. In the Democratic Republic of the Congo (DRC), national-level evidence on women's awareness of CC and its associated factors remains limited. AIMS: This study aimed to assess the level of cervical cancer awareness and identify factors associated with awareness among women of reproductive age in the DRC. INTRODUCTION: Cervical cancer (CC) is a major public health concern, ranked as the fourth leading cause of death. Evidence shows that CC is preventable if diagnosed at the early stages. In the Democratic Republic of the Congo (DRC), there is limited evidence at the national level and on factors associated with CC awareness among women of reproductive age. This study aimed to address this gap. METHODS: The study analysed secondary data from a total weighted sample of 27 583 women aged 15-49, drawn from the 2023-2024 DRC Demographic and Health Survey (DRCDHS). The dependent variable was CC awareness, and the independent variables were the sociodemographic characteristics of a woman. Descriptive, bivariable and multivariable analyses were conducted. A significant factor was determined at p-value < 0.05 at 95% confidence intervals (CIs). RESULTS: The overall CC awareness among women of reproductive age in DRC was 21.3% (95% CI = 19.5-23.2). Logistic regression results revealed that women aged 25-34 (AOR = 1.36; 95% CI = 1.12-1.66) and 35-49 (AOR = 1.60; 95% CI = 1.27-2.02), women who were residing in urban areas (AOR = 1.53; 95% CI = 1.06-2.20), women with primary education (AOR = 1.45; 95% CI = 1.03-2.04), secondary education and above (AOR = 1.73; 95% CI = 1.22-2.45), employed women (AOR = 1.48; 95% CI = 1.20-1.84), women who had been examined for breast cancer (AOR = 4.72; 95% CI = 2.91-7.67), women who had been listening to radio (AOR = 1.60; 95% CI = 1.28-1.99), women who had visited health facility last 12 months (AOR = 1.63; 95% CI = 1.35-1.97), Christian (AOR = 2.35; 95% CI = 1.06-5.21), use internet (AOR = 1.67; 95% CI = 1.23, 2.28), reading newspaper/magazine (AOR = 1.33; 95% CI = 1.01-1.76) and delivered at health facility (AOR = 1.53; 95% CI = 1.18-1.98) were statistically significant associated with having CC awareness compared to their counterparts. CONCLUSION: The study revealed overall suboptimal CC awareness among women of reproductive age in DRC. Although health education interventions should target all women of reproductive age, special attention should be given to younger women aged 15-24 years, those with no formal education and those living in rural areas, as these subgroups demonstrated particularly lower awareness levels. Strengthening tailored interventions for these vulnerable groups may therefore improve awareness within the broader reproductive-age population and the community at large.