396P - Determinants of visiting a referral hospital for cervical cancer screening at Uganda Cancer Institute

Background

Despite the many cervical cancer prevention interventions recommended and supported by WHO and partners of low- and middle-income countries; the burden of cancer is high in Uganda and the East African region. Little is known about factors associated with participating in screening at a primary health facility (PHF) and referral to a high-level facility.

Methods

A cross-sectional study was conducted from February to March 2018 at Uganda Cancer Institute (UCI) among women visiting for cervical cancer screening. A structured questionnaire was used. Women suspected for cervical cancer and provided consent were enrolled and administered the questionnaire. Ethics review and approval was obtained from UCI research and ethics committee. A Stata version 14.1 software was used and Chi-square tests and multivariate logistic regression analyses performed.

Results

Among 522 women enrolled, only 3.26% (17) had a formal referral note and 62.64% (327) had participated in cervical cancer screening before visiting UCI. There was a 17.65% false-positive rate among the referred women suspected with cervical cancer. 67.18% (131) among those who had never screened reported personal beliefs as a factor deterring their participation. Most women were aged between 35-44 years old (ORs=2.45, 95% CI = 1.61-3.72) who were divorced/widowed (ORs=1.89, 95% CI = 1.07-3.34) and drinking alcohol (ORs=0.51, 95% CI = 0.31-0.83). Among the referred women, 17.65% delayed to honour a referral request for more than a month because of socio-economic challenges. Factors such as high education level (ORs=0.11, 95% CI = 0.02-0.48) and confirmatory tests (ORs=6.10, 95% CI = 1.93-19.31) done at UCI were associated with referrals.

Conclusions

The present study identified factors associated with participation in screening at a PHF and referral to a high-level facility, which provides better understanding of lost follow-up after screening. Awareness in high risk groups, increase of screening facilities and integration of screening services with existing health programs is necessary.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Uganda Cancer Institute-African Development Bank capacity building fund.

Disclosure

The author has declared no conflicts of interest.