Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=41168761
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Assessing the socioeconomic inequalities in cervical cancer screening in
sub-Saharan Africa: a decomposition analysis
#MMPMID41168761
Okyere J
; Aboagye RG
; Ahinkorah BO
; Essuman MA
; Seidu AA
; Wongnaah FG
; Baiden F
Int J Equity Health
2025[Oct]; 24
(1
): 297
PMID41168761
show ga
BACKGROUND: Cervical cancer remains one of the most diagnosed diseases among
women in sub-Saharan Africa (SSA). Despite global efforts to eliminate this
disease, the incidence rate in SSA continues to rise due to barriers to
screening, vaccination, and treatment access. Numerous studies have examined the
barriers women face in accessing cervical cancer screening, but little has been
reported about inequality. The few available studies are limited to single
countries. In this study, we examined the socioeconomic inequalities in cervical
cancer screening in SSA. METHODS: Data from the Demographic and Health Surveys of
10 sub-Saharan African countries was used for the analysis. A weighted sample of
46,471 women aged 30-49 was included in the study. We used wealth index and
educational attainment as measures of socioeconomic status. Socioeconomic
inequalities in cervical cancer screening were constructed using concentration
curves. We then computed the concentration index (CIX) to quantify the magnitude
of socioeconomic inequality. A decomposition analysis was conducted to examine
the factors associated with socioeconomic inequality in cervical cancer
screening. RESULTS: The concentration curve was below the line of equality for
all countries, indicating a disproportionate concentration of cervical cancer
screening uptake among the wealthy and educated, except for Mauritania, where
educational attainment was insignificant. With wealth index, positive
concentration indices, indicating being advantaged with higher screening uptake
were found among women in the richest wealth index (CIX?=?0.753), those with
incomplete secondary (CIX?=?0.195), complete secondary (CIX?=?0.378) and higher
education (CIX?=?0.575), and women who were working at the time of the survey
(CIX?=?0.031). Similarly, positive concentration indices were observed among
women with primiparity (CIX?=?0.279) and multiparity (CIX?=?0.128), those who
read newspapers/magazines (CIX?=?0.335), listened to radio (CIX?=?0.108), and
watched television (CIX?=?0.301). With level of education, women with complete
primary (CIX?=?0.151), incomplete secondary (CIX?=?0.478), complete secondary
(CIX?=?0.761) and higher education (CIX?=?0.916), those in the richer
(CIX?=?0.077) and richest wealth index (CIX?=?0.391), those currently working
(CIX?=?0.022), women with primiparity (CIX?=?0.0.325) and multiparity
(CIX?=?0.147), those who were exposed to read newspapers/magazines (CIX?=?0.511),
listened to radio (CIX?=?0.109), and watched television (CIX?=?0.220) had
positive concentration indices, indicating being advantaged with higher cervical
cancer screening uptake. CONCLUSION: Cervical cancer screening in SSA is
characterized by pro-rich and pro-higher educational inequalities. Existing
interventions could be restructured to prioritise accessibility and inclusion,
particularly for women from poorer households and those with a lower level of
education. The findings are crucial for policymakers and public health
practitioners aiming to address cervical cancer screening disparities in SSA.
free
free
free
