Determinants and Outcomes of Cervical Cancer Screening in Nyanga District, Manicaland, Zimbabwe 2024

Abstract

Cervical cancer remains a significant public health challenge in low- and middle-income countries, ranking as the fourth most diagnosed malignancy among women worldwide. Sub-Saharan Africa bears a disproportionate burden of cervical cancer, with Zimbabwe among the countries most severely affected. The World Health Organization estimates that Zimbabwe experiences a cervical cancer mortality rate of 17.6%, primarily impacting poor, rural women. Importantly, cervical cancer is treatable if detected early.This study investigates the determinants and outcomes of cervical cancer screening in Nyanga District, Manicaland, Zimbabwe, in 2024. Prompted by persistently low uptake of Visual Inspection with Acetic Acid and Cervicography (VIAC) screening, which has hindered the district from meeting its annual screening targets, this research aimed to identify factors influencing screening behaviors and outcomes. VIAC is the district's sole cervical cancer screening method, complemented by cryotherapy for treating precancerous lesions.A 1:1 case-control study design was utilized to examine demographic, socio-economic, socio-cultural, and health-related factors affecting cervical cancer screening. Data were collected through interviewer-administered questionnaires and analyzed using Epi Info, with additional insights gathered from key informants.The findings revealed that all participants were aware of cervical cancer screening, with 87.5% demonstrating knowledge of cervical cancer risk factors. The mean age of participants was 37 years, and screening uptake increased with increasing age and parity. Educational attainment significantly influenced screening, with higher rates observed among women with secondary or tertiary education. Socio-economic barriers, including financial constraints (47%) and inadequate healthcare facilities (64.2%), were major impediments to screening, as only two facilities in the district provided VIAC services. Additional barriers included fear of diagnosis, stigma, and lack of awareness.This study underscores the urgent need to address structural, socio-economic, and cultural barriers to enhance cervical cancer screening uptake in Nyanga District. Improved healthcare infrastructure, targeted awareness campaigns, and financial support are critical to reducing the cervical cancer burden and achieving equitable access to screening cervical cancer.