Trends in cervical cancer screening uptake and cytology outcomes at Kiambu Level 5 Hospital, Kenya

Abstract

Introduction: Cervical cancer remains a major public health concern in Kenya, yet facility-level data describing Pap smear screening uptake and cytology outcomes within routine health services are limited. This study described trends in Pap smear screening uptake and patient cytology outcomes at Kiambu Level 5 Hospital (KL5H) between 2014 and 2020. Methods: We conducted a facility-based retrospective study utilising data extracted from the cervical cancer screening and treatment daily activities register (MOH 412) and the Pap smear laboratory register. Descriptive statistical analysis was performed using Stata version 12. Results: A total of 3,457 women underwent Pap smear screening within the study period. Among these, 33.0% (1,147/3,457) were aged 40–49 years, 34.3% (1,192/3,457) were HIV positive, and 62.2% (2,160/3,457) were index screening tests. The Pap smear results indicated that the majority (94.6%) were negative for intraepithelial lesions or malignancy, while 5.4% exhibited premalignant Pap smears. Only 0.06% of the participants had malignant Pap smear results. Annual Pap smear screening increased from 370 women in 2014 to a peak of 978 in 2019, before declining to 551 in 2020. Conclusion: Most women screened had normal cytology results, with a small proportion showing premalignant or malignant lesions. Pap smear screening uptake at KL5H increased following clinic establishment, with fluctuations over time and a decline observed in 2020. These findings underscore the importance of sustaining facility-based cervical cancer screening services and support the need for targeted efforts to maintain and enhance screening coverage in the county.