Determinants of precancerous cervical lesions among women screened for cervical cancer at Debre Markos town public health facilities, Ethiopia
摘要
The potential for precancerous cervical lesions to develop into cervical cancer over time is a significant public health concern in low and middle-income countries, including Ethiopia. The Ethiopian government is supporting the prevention of cervical cancer by acetic acid screening and vaccinations. However, the determinants of precancerous cervical lesions were not well studied. Therefore, this study aimed to identify determinants of pre-cancerous cervical lesions among women screened for cervical cancer at Debre Markos town public health institution, Ethiopia, 2025.
MethodsAn institution-based unmatched case-control study was conducted among 340 women (85 cases and 255 controls) who underwent cervical cancer screening. Cases were selected consecutively, and controls were selected using systematic random sampling. Data were collected through a structured interviewer-administered questionnaire and chart review. Data were entered using Epi-Data Version 4.6 and then transferred to STATA 15 for analysis. Descriptive statistical analysis computed frequencies and presented them with texts and tables. To determine the factors linked to precancerous cervical lesions, this study used bivariate logistic regression analysis (P < 0.25), multivariable logistic regression (P < 0.05), and odds ratios with 95% Confidence Interval (CIs). The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the model’s fitness.
ResultA total of 85 cases and 255 controls were included in this study, resulting in a 100% response rate. Age above 40 years adjusted odds ratio (AOR): 2.99 (1.03–8.90), rural residence AOR = 3.69 (1.46–9.36), Live alone AOR = 4.86 (2.05–11.5), history of STIs AOR = 5.3 (2.12–13.3), genital mutilation AOR = 5.98 (2.37–15.08), early initiated sexual intercourse AOR = 3.47 (1.27–9.5), having HIV positive AOR = 7.04 (2.75–17.9), and having two or more lifetime sexual partners AOR = 6.87 (2.74–17.2) were determinants of precancerous cervical lesion.
ConclusionsThis study highlights the importance of behavioural, biological, and socio-cultural factors in the development of precancerous cervical lesions among women in Ethiopia. HIV infection, history of sexually transmitted infections, multiple sexual partners, and female genital mutilation were identified as key determinants requiring targeted prevention and screening interventions. Strengthening integrated cervical cancer screening services may improve early detection and reduce the burden of cervical cancer in Ethiopia.