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Impact of cervical cancer-related stigma on screening uptake in Dakar and Kedougou, Senegal: A context-specific
Fatou Bintou Seck1, Saria Awadalla2, Fatoumata Binetou Diongue1
1Institute of Health and Development, Cheikh Anta Diop University, Dakar, Senegal.
Abstract:
Cervical cancer is a major public health problem, but it can be prevented through screening and treatment of precancerous lesions. The aim of this study was to assess the association between cervical cancer-related stigma and prior cervical cancer screening uptake among women in the Dakar and Kédougou regions of Senegal. A quantitative descriptive and analytical cross-sectional study was carried out in the Dakar and Kédougou regions. The study population consisted of women aged 25-69. Sampling was based on a two-stage cluster sampling methodology. Past participation in screening was self-reported, and an index of stigma was developed to quantify the level of cervical cancer related stigma in the study population. The items used to develop this index covered several domains that have been shown to be powerful predictors of stigma. Data were analyzed with R 4.5.0 software. Logistic regression was performed (5% alpha). A total of 287 women had data on their screening status, with only 15.7% reporting having undergone one or more screenings in the past. The mean age of participants was 36.23, and the majority (68.6%) were married and living in monogamous households. After adjustment for age, marital status and education level, higher stigma scores were associated with lower odds of screening (OR=0.58, 95% CI 0.38-0.83, p = 0.006). Cervical cancer stigma was significantly associated with lower odds of screening uptake. A better understanding of this barrier will enable us to better adapt strategies to combat this disease. Setting up a navigation program for this screening could help improve access to this service by removing the stigma barrier and any other major obstacle to screening. Our stigma index provides a comprehensive assessment of stigma and represents a novel tool that can be adapted for future research, including the evaluation of stigma reduction following implementation of our patient navigation intervention.