Eiman Alawadhi

Disparities in the Uptake of Cervical Cancer Screening in Kuwait: A Cross-Sectional Analysis of the Nationwide WHO STEPS Survey

Cervical cancer is projected to increase by 48% in Kuwait by 2035. Detecting cervical cancer early can prevent its progression. Given the paucity of prior research in Kuwait, we aimed to investigate cervical cancer screening (CCS) prevalence using a representative sample and assess disparities in CCS uptake among Kuwaiti women. We obtained a representative Kuwaiti sample (n=3915) through WHO's STEPwise approach to noncommunicable disease risk factor surveillance (STEPS). Demographic, socioeconomic, and health data were analyzed for women aged 18-69 (n=2292) with available CCS information. Results were age-weighted, and analysis included descriptive statistics, bivariate analysis, and multivariable logistic regression adjusted for sociodemographics and health status. Weighted CCS prevalence was 15.2% (95% CI [13.7-16.7]). Older women had higher odds of CCS; 60-69 age group was four times more likely to be screened than the 18-29 group (OR 4.0 [2.6-9.4]). Married (OR 5.0 [2.6-9.4]), divorced/widowed (OR 5.2 [2.6-11.3]) women, retirees (OR 2.1 [1.3-3.5]), those with high school degree or higher (OR 2.7-2.8 [1.1-7.0]), and those with hypertension (OR 1.7 [1.1-2.4]) had higher odds of screening. Overweight/diabetic women had 40% lower odds of CCS (OR 0.6 [0.4-0.9]), and non-Capital residents had 60% lower odds (OR 0.4 [0.3-0.6]). CCS uptake among Kuwaiti women is minimal, with disparities in age, education, residence, marital status, employment, and health issues. Efforts are needed for organized, widely promoted, physician-endorsed screening programs  addressing such disparities and Kuwait's cultural norms.