review · PLoS ONE
Cervical cancer remains a major public health challenge in developing nations such as Ethiopia, where the uptake of preventive screening is substantially lower than in developed countries. A meta-analysis of forty-four studies covering over twenty-eight thousand Ethiopian women found that the overall rate of cervical cancer screening utilization is very low, estimated at approximately eight per cent, or five and a half per cent after adjusting for publication bias. Utilization was comparatively higher among HIV-positive women and healthcare workers than in the general population. Having adequate knowledge about screening significantly increased the likelihood of test uptake by over three times. Furthermore, holding a favourable attitude towards screening increased the odds of uptake by more than six times. Expanding national awareness initiatives is essential to raise screening rates across the country.
Cervical cancer can be effectively prevented through timely screening, yet service uptake in Ethiopia remains critically low. By demonstrating that personal knowledge and positive attitudes are decisive drivers of uptake, this evidence helps public health planners and healthcare organisations direct resources towards targeted education and behavioural interventions, ultimately enabling earlier detection and better survival outcomes.
The abstract does not indicate a commercial application pathway. The findings are intended for public health authorities, health communication planners, and non-governmental organisations to design targeted educational interventions and awareness programmes. Any resulting initiatives would represent applied public health strategies rather than a commercial product or technology.
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INTRODUCTION: Cervical cancer is a major public health problem, particularly in resource-limited settings. The use of vaccination and screening tests has reduced the burden of cervical cancer in developed countries. However, the situation is quite the reverse in developing countries, including Ethiopia. Hence, this study aimed to estimate the pooled impact of knowledge and attitude on the prevalence of cervical cancer screening service utilization rates among Ethiopian women. METHODS: Studies that examined cervical cancer screening service utilization among women in Ethiopia were searched from five international databases. Cochran's Q chi-square and the I-squared test statistics were used to check the presence of heterogeneity among the included studies. The funnel plot and Egger's regression tests were also used to assess the presence of publication bias. A weighted DerSimonian and Laird random-effects model was employed. Subgroup analysis was performed by the study population concerning the prevalence of cervical cancer screening service utilization rates. Sensitivity analysis was also conducted to assess the effect of a single study on the pooled estimates. Data analysis was performed using STATA™ Version 14 software. RESULTS: A total of 44 studies with 28,186 study participants were included. The estimated pooled prevalence of cervical cancer screening service utilization was 8.11% (95% CI: 7.26, 8.97). After adjustment for publication bias with the trim and fill analysis, the estimated prevalence rate appeared to be 5.47% (95% CI: 4.66, 6.28). The prevalence of cervical cancer screening service utilization was higher among HIV-positive women, 16.85%, and in studies conducted among health care workers, 10.24%, than the general population. The pooled effect of knowledge on the utilization of cervical cancer screening tests among Ethiopian women was statistically significant (AOR = 3.20, 95% CI: 1.63, 6.31). Similarly, the pooled estimated odds of utilizing cervical cancer screening tests were 6.1 times higher (AOR = 6.09, 95% CI: 1.09, 34.36) among women who had a favorable attitude towards the screening tests. CONCLUSION: Knowledge and attitude had a significant impact on the prevalence of cervical cancer screening test utilization rates among women in Ethiopia. However, the prevalence of cervical cancer screening service utilization among Ethiopian women is very low. Hence, large-scale awareness programs and situation-based strategies need to be designed to increase the uptake of cervical cancer screening services in the country.
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DOI: 10.1371/journal.pone.0239927
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