Cervical cancer screening in sub-urban area of Banten and factor associated with uptake of screening

Abstract

Background Cervical cancer ranks as 2nd leading cause of female cancer in Indonesia. Early detection of cervical cancer is crucial for early treatment and reduce risk of mortality. Despite the evidence of cervical cancer screening is associated with decrease mortality from this disease, the uptake for cervical cancer screening among Indonesian women in suburban area of Banten remains low. The aim of this study is to discover factors that associate with uptake of cervical cancer screening and report on cervical cancer prevalence among women in suburban area of Banten. Methods This is a cross sectional study that took the mass screening in 3 different primary health care in Banten, Indonesia. We included female who had never done screening for cervical cancer and aged 21-65 years old. Cervical sample were collected for Papanicolaou smear and evaluated by pathologist. Results Pap smears of 309 females were taken. It was observed that 74,11% (n = 229) of females were negative for cervical intraepithelial lesion or malignancy. Our data showed that 13,5% (n = 42) had bacterial vaginosis, 6.14% (n = 19) had candida infection. Respectively,for low grade squamous intraepithelial lesion (LSIL) and high grade intraepithelial lesion were 2,26%( n = 7) and 1,61 % (n = 5). Cervical cancer was positive for 0.97% (n = 3) and 1.29% (n = 4) had atropic vaginitis. The significant predictor for uptake of cervical cancer screening were being married, older age, and knowing a person with cervical cancer with p value 0.004, 0,037 and <0,001. The only significant factor that contribute to reduce uptake of screening is did not know where to go for screening and the price of screening with p value of 0,024 and 0.017. Conclusions Mass screening and public education is a crucial step to reduce morbidity and mortality of cervical cancer. Poor hygiene environment in suburban region increase incidence of infection that lead to causative factors for cervical cancer. Intensification of primary health care for cancer screening is needed to reduce the national burden of cervical cancer in Indonesia. Legal entity responsible for the study Faculty of Medicine, Pelita Harapan University. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.