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Lifetime Prevalence of Cervical Cancer Screening in 55 Low-And Middle-Income Countries Publisher Pubmed



Lemp JM1 ; De Neve JW1 ; Bussmann H2 ; Chen S1, 3 ; Mannegoehler J4, 5 ; Theilmann M1 ; Marcus ME6 ; Ebert C7 ; Probst C1, 8 ; Tsabedzesibanyoni L9 ; Sturua L10 ; Kibachio JM11, 12 ; Moghaddam SS13 ; Martins JS14 Show All Authors
Authors
  1. Lemp JM1
  2. De Neve JW1
  3. Bussmann H2
  4. Chen S1, 3
  5. Mannegoehler J4, 5
  6. Theilmann M1
  7. Marcus ME6
  8. Ebert C7
  9. Probst C1, 8
  10. Tsabedzesibanyoni L9
  11. Sturua L10
  12. Kibachio JM11, 12
  13. Moghaddam SS13
  14. Martins JS14
  15. Houinato D15
  16. Houehanou C15
  17. Gurung MS16
  18. Gathecha G11
  19. Farzadfar F17
  20. Drydenpeterson S4, 18
  21. Davies JI19, 20
  22. Atun R21, 22
  23. Vollmer S6
  24. Barnighausen T1, 21, 23
  25. Geldsetzer P1, 24

Source: JAMA - Journal of the American Medical Association Published:2020


Abstract

Importance: The World Health Organization is developing a global strategy to eliminate cervical cancer, with goals for screening prevalence among women aged 30 through 49 years. However, evidence on prevalence levels of cervical cancer screening in low-and middle-income countries (LMICs) is sparse. Objective: To determine lifetime cervical cancer screening prevalence in LMICs and its variation across and within world regions and countries. Design, Setting, and Participants: Analysis of cross-sectional nationally representative household surveys carried out in 55 LMICs from 2005 through 2018. The median response rate across surveys was 93.8% (range, 64.0%-99.3%). The population-based sample consisted of 1136289 women aged 15 years or older, of whom 6885 (0.6%) had missing information for the survey question on cervical cancer screening. Exposures: World region, country; countries' economic, social, and health system characteristics; and individuals' sociodemographic characteristics. Main Outcomes and Measures: Self-report of having ever had a screening test for cervical cancer. Results: Of the 1129404 women included in the analysis, 542475 were aged 30 through 49 years. A country-level median of 43.6% (interquartile range [IQR], 13.9%-77.3%; range, 0.3%-97.4%) of women aged 30 through 49 years self-reported to have ever been screened, with countries in Latin America and the Caribbean having the highest prevalence (country-level median, 84.6%; IQR, 65.7%-91.1%; range, 11.7%-97.4%) and those in sub-Saharan Africa the lowest prevalence (country-level median, 16.9%; IQR, 3.7%-31.0%; range, 0.9%-50.8%). There was large variation in the self-reported lifetime prevalence of cervical cancer screening among countries within regions and among countries with similar levels of per capita gross domestic product and total health expenditure. Within countries, women who lived in rural areas, had low educational attainment, or had low household wealth were generally least likely to self-report ever having been screened. Conclusions and Relevance: In this cross-sectional study of data collected in 55 low-and middle-income countries from 2005 through 2018, there was wide variation between countries in the self-reported lifetime prevalence of cervical cancer screening. However, the median prevalence was only 44%, supporting the need to increase the rate of screening. © 2020 American Medical Association. All rights reserved.
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