pone.0317641.t005 -

BackgroundUganda has the highest prevalence and incidence of cervical cancer in the East African region, with 80% of women diagnosed at advanced stage when survival is minimal. Literature on uptake of cervical cancer screening is limited in Uganda and thus womens’ knowledge and uptake of cervical cancer screening in the general population remains unknown. This study examined this gap of knowledge among women aged 25–65 years, across rural, urban and semi urban communities in a Ugandan district to inform design of targeted future cervical cancer screening programs in the country.MethodsThis descriptive cross-sectional study was conducted in Wakiso district, Uganda in May 2024 among 783 eligible women. Face-to-face interviews were conducted. Uptake of cervical cancer screening (outcome of interest) was dichotomously (yes/no) assessed. Knowledge of cervical cancer disease was assessed using the AWACAN validated tool, knowledge of cervical cancer screening was assessed using a set of ten (10) questions adapted from previous studies elsewhere, and all were measured on a Likert scale. Univariate, bivariate, and multivariable Poisson regression models with robust variance were performed using Stata software version 17.ResultsRespondents’ median age was 31 years (IQR 27–39 years). Majority (89.5%, 701/783) had heard of cervical cancer, and 90.6% (635/701) were aware of screening. Median knowledge score on signs and symptoms, risk factors and cervical cancer screening was 8.0 (IQR = 5–10), 8.0 (IQR = 5–11) and 7.0 (IQR = 4–10) respectively, and 54.3% had high knowledge about cervical cancer screening. Uptake of cervical cancer screening was 33.4%. Living in urban areas (aPR = 1.41, 95% CI: 1.05–1.88), being the ages 40–49 years (aPR = 1.76, 95% CI: 1.36–2.27), 50 years and above (APR = 2.16, 95% CI: 1.53–3.04), smoking (aPR = 1.39, 95% CI: 1.05–1.86), partner involvement (aPR = 2.61, 95% CI: 2.12–3.21), high knowledge about cervical cancer screening (aPR = 3.29, 95% CI: 2.35–4.60), and living with HIV (aPR = 1.66, 95% CI: 1.66–2.13) were significantly associated with higher uptake of cervical cancer screening among women in this setting.ConclusionKnowledge of cervical cancer screening was high, but the uptake of cervical cancer screening was lower than the recommended population coverage by WHO and Uganda national guidelines. There is need to improve accessibility to cervical cancer screening, increase nationwide cervical cancer awareness campaigns focusing on high-risk age groups and design targeted, tailored, culturally and socially sensitive interventions for young women aged 25–39 years to improve cervical cancer screening in Uganda.背景 乌干达是东非地区宫颈癌患病率与发病率最高的国家，80%的女性确诊时已处于晚期，此时生存率极低。目前乌干达境内关于宫颈癌筛查普及率的相关研究文献较为匮乏，因此普通人群中女性对宫颈癌筛查的认知水平与实际参与情况仍不明确。本研究针对乌干达某行政区内农村、城市及半城市社区的25~65岁女性展开，旨在填补这一认知空白，为该国未来制定针对性的宫颈癌筛查方案提供依据。方法 本研究为描述性横断面研究，于2024年5月在乌干达瓦基索区开展，共纳入783名符合条件的女性。研究采用面对面访谈的方式进行。以二分类（是/否）评估宫颈癌筛查参与率（本研究的主要结局指标）。采用经验证的AWACAN工具评估女性对宫颈癌疾病的认知，采用从既往其他地区研究改编的10道题目评估其对宫颈癌筛查的认知，所有认知指标均采用李克特量表进行量化。使用Stata 17统计软件进行单变量、双变量分析及稳健方差多变量泊松回归分析。结果 研究对象的年龄中位数为31岁（四分位间距27~39岁）。绝大多数（89.5%，701/783）的女性听闻过宫颈癌，其中90.6%（635/701）了解宫颈癌筛查。女性针对宫颈癌体征与症状、危险因素及宫颈癌筛查的认知得分中位数分别为8.0（四分位间距5~10）、8.0（四分位间距5~11）与7.0（四分位间距4~10），且54.3%的女性对宫颈癌筛查具有较高认知。宫颈癌筛查参与率为33.4%。在本研究场景中，居住于城市地区（调整后风险比aPR=1.41，95%置信区间CI:1.05~1.88）、年龄处于40~49岁（aPR=1.76，95%CI:1.36~2.27）、50岁及以上（aPR=2.16，95%CI:1.53~3.04）、有吸烟史（aPR=1.39，95%CI:1.05~1.86）、有伴侣参与支持（aPR=2.61，95%CI:2.12~3.21）、对宫颈癌筛查具有较高认知（aPR=3.29，95%CI:2.35~4.60）以及感染人类免疫缺陷病毒（HIV）（aPR=1.66，95%CI:1.66~2.13）均与宫颈癌筛查参与率提升显著相关。结论 本次研究中女性对宫颈癌筛查的认知水平较高，但宫颈癌筛查参与率低于世界卫生组织（WHO）及乌干达国家指南推荐的人群覆盖率。乌干达亟需提升宫颈癌筛查的可及性，开展针对高风险年龄组的全国性宫颈癌认知宣传活动，并为25~39岁的年轻女性设计具有针对性、定制化且符合文化与社会情境的干预方案，以提升该国宫颈癌筛查覆盖率。