Determinants of cervical cancer screening uptake in Lesotho: evidence from 2024 Demographic and Health Survey data
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Cervical cancer affects approximately 13.1 women per 100,000 globally, with its incidence rates varying significantly across regions. Low- and middle-income countries bear the highest burden, partly due to inadequate access to preventive measures, such as regular screening and timely treatment. This study aims to identify the determinants of cervical cancer screening uptake among women of reproductive age in Lesotho, using data from the most recent Demographic and Health Survey. A total of 3,250 women were included in this study, utilizing data from the 2024 Lesotho Demographic and Health Survey. The analysis was conducted using STATA version 17.0. A multilevel mixed-effects logistic regression model was employed to identify potential factors associated with the outcome variable. Variables with p-values less than 0.05 were considered statistically significant. The practice of cervical cancer screening was found to be 38.90% [95% CI: 37.20-40.60]. The odds of cervical cancer screening uptake were significantly higher among women aged 20-49 years compared to those aged 15-19 years. Women with primary and secondary education levels were approximately 5.8 times more likely to undergo screening [AOR = 5.779, 95% CI: 1.1-30.0 and AOR = 5.79, 95% CI: 1.0-30.6], respectively, than women with no formal education. At the community level, women with high media exposure were 1.6 times more likely to be screened [AOR = 1.56, 95% CI: 1.05-2.33] compared to those with low media exposure. Cervical cancer screening rates were found to be low in this study. To encourage screening behavior, raising awareness through accessible media platforms and providing education to women could be effective. Additionally, older age was identified as a factor positively associated with screening uptake. The government should prioritize cervical cancer prevention and screening, as it remains the most cost-effective method for preventing cervical cancer.