Cervical Cancer Screening Utilization and Barriers to Uptake in Ethiopia: An Umbrella Review

Cervical cancer (CCa) is the second most common type of cancer and a leading cause of death among adult women in Ethiopia. However, at the moment, there is a lack of evidence that can be generalizable as a whole to the country regarding the uptake of cervical cancer screening.

The aim of this review was to assess the pooled estimated uptake of CCa and to identify the major barriers to cervical cancer screening (CCS) uptake among adult women in Ethiopia.

The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) with a registration number of CRD42022353954. The data were searched electronically using Google Scholar, PubMed, Medline, and Web of Science search engines. The heterogeneity of the literature was assessed using Cochran's (Q) test and Higgin's and Thomson's (I²) statistic. The Rosenthal approach, Fail-safe N method, Egger's test with a P-value <0.05, and funnel plot symmetry were used to detect publication bias. Random effect analysis was used to find out the pooled effect size. The Stata 17 software was used to perform analysis.

The pooled estimated uptake of CCS was 13.08% (POR 13.08; 95% CI: 10.24, 15.93; I² = 81.93%). Common factors associated with uptake of CCS were adequacy of knowledge (POR = 3.48; 95% CI: 2.74, 4.23; I² = 0%), attitudes of women (POR = 3.51; 95% CI: 2.96, 4.07; I² = 0%), and perceived susceptibility (POR = 4.03; CI: 2.68, 5.39; I² = 46.38%). A slightly high degree of overlap of studies was observed.

The pooled estimated CCS is low. Factors like adequacy of knowledge of CCa, attitudes of women, and perception of susceptibility among women showed a significant association with cervical cancer screening uptake. Creating a platform where women can get adequate and focused information about cervical cancer and screening is crucial.