SCREENING ATTENDANCE, INTENTION TO ATTEND,HEALTH LITERACY AND ASSOCIATED FACTORS OF BREAST OR CERVICAL CANCERS AMONG WOMEN IN GEDIO ZONE, ETHIOPIA, 2023: BASED ON PROTECTION MOTIVATION THEORY

Abstract

Introduction: Breast and cervical cancers are the most frequent and fatal cancers among women. Early detection has a significant impact on the success of the treatment. However, a limited study was available that assessed both cancers simultaneously and involved health literacy in relation to cancer screening behaviors. This study is the first critical step in designing interventions that improve cancer early detection. Objective: Aim to assess the magnitude of screening attendance, intention to attend, health literacy of breast or cervical cancers, and their predictors among women aged 30-49 years old in Gedeo Zone, South Ethiopia, in 2023 based on protection motivation theory. Method: A community-based cross-sectional study design was conducted from April 30 to May 30 on 594 women's by employing a multi-stage cluster sampling technique. Data collection was performed using pretested, structured interviewer-administered questionnaires via the kobo Collect app. IBM SPSS version 25 was used for statistical analyses and the characteristics of participants were described by frequencies and percentages for categorical variables. A binary logistic regression model was used to identify factors associated with outcomes. In bi-variable analysis variables with a p-value ≤ 0.25 were candidates for multivariable analysis. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 were declared statistically significant. Result: A total of 554 women were included in the study, yielding a response rate of 93.2%. Of them, 120 (21.7%), 95% CI: [18%, 25%] were screened for cervical cancer, 30(5.4%) 95% CI: [4%, 7%] for breast cancers and 132 (23.8%) 95% CI: [20%, 27%] for two-female cancers (screened either for breast or cervical or both). In this study’s, 342 (61.7%) 95% CI: [58%, 66%] were had the intention to attend screening and 216(39%) 95% CI: [35%, 43%] adequate health literacy of breast and cervical cancers. Age of 45-49 [AOR = 4.18, 95% CI (1.59, 10.9)], college and above educational status [AOR = 5.49, 95% CI (2.01, 13.1)], having family or friend history of breast or cervical cancer [AOR = 5.55, 95% CI (2.47, 12.5)] ,short anticipated time to seek help [AOR 4.66(1.31, 11.7), adequate health literacy AOR = 6.98, 95% CI (2.82, 13.3) ], high self-efficacy [AOR 2.32, 95% CI (1.08, 4.96)], were positive factors; while high response cost [AOR 0.19, 95% CI (0.08, 0.50)] were negative factors associated with screening attendance. Having a family or friend history of breast or cervical cancer [AOR = 7.18, 95%CI (3.59, 14.4)], short anticipated time to seek help [AOR = 4.75, 95% CI (2.41, 9.39)], adequate health literacy [AOR = 2.26, 95%CI (1.15, 4.48)], high perceived severity [AOR = 2.96, 95% CI (1.64, 5.37)], high self-efficacy [AOR = 3.93, (1.76, 8.77)] were positive factors associated with screening intention to attend. Urban residence [AOR 1.96(1.19, 3.22), short anticipated time to seek help [AOR = 4.01, 95% CI (2.15, 7.49)], good knowledge [AOR = 4.51, 95% CI (1.14, 13.9)], ever used contraceptives [AOR = 2.51, 95% CI (1.24, 5.11)] were positive factors associated with health literacy. Conclusion and Recommendation: This study found that screening attendance and health literacy of breast and cervical cancers among women were low. Further, more women in this study were found to have had cervical cancer screening compared to women who had ever been screened for breast cancer. More than half of women had the intention of attending screenings in the future. Therefore, to improve screening attendance and intention to attend designing health literacy-focused screening policies and provision of factors should have to be addressed at each level of health care. Also, to enhance health literacy emphasis should be given to rural residents and providing health education to enhance their awareness.