Participation of women in cervical cancer screening is a key to fight against this disease because screening helps in the early detection of precancerous lesions which can be treated. In order to contribute to the promotion of this secondary prevention method, we established as goal to determine the frequency and associated factors to the absence of cervical cancer screening in a women population attending gynecological consultation.
We found a low rate of cervical cancer screening i.e. 26.7% (267/1000) among the participants. The same result was obtained in two studies done in Kenya and in Nigeria with a respective screening rate of 21% and 9.7% [10, 11]. Reason for this low rate in our study was mainly negligence. Indeed, participants although being informed would not give great importance to screening. Some on the other hand were not aware of the existence of cervical cancer screening or were waiting for a healthcare worker prescription.
Better screening rates (72%) were obtained in a study in Botswana. The study population had a high HIV prevalence and therefore a high risk of precancerous lesions [12]. This would incite the healthcare workers to pay more attention to cervical cancer screening in that population.
Age lower than 35 years old was associated to the absence of cervical cancer screening. This result corroborates those from other studies where patients aged 30-40 years old and above were the most adherent to the screening [11, 13]. The poor adhesion of young women would be due to social perceptions on cervical cancer. In fact, we found among barriers to screening: ignorance; some women thought that « It is a disease for women who gave birth a lot», and so who are older. Sensitization must be therefore reoriented towards this young population.
Islam was significantly associated with the absence of performing cervical cancer screening. A similar result was found in a study in Uganda [14]. Some researchers have shown that for socio-cultural and religious reasons, husbands play a preponderant role in making decisions concerning access to health care [15]. Some Muslim participant in our study were waiting for the authorization of their husbands to access health services. Adaptation of communication strategies to focus also on men could therefore contribute to improve women participation to screening.
Employed women had a greater chance to be screened for cervical cancer. This could be explained by the fact that they are more exposed to get the information and they have more financial resources to access screening even without campaigns. This result is similar to other African studies [12, 13].
Limits
This study was done in an urban area and in a reference hospital. Therefore, the results obtained could not be applicable to the general population. Another limit of this cross-sectional study is that a causality link cannot be established between identified associated factors and the absence of cervical cancer screening.