Abstract 4961: Bridging gaps in cervical cancer screening: Prevalence and key predictors among women aged 25-59 years in Eswatini

Abstract Background: Cervical cancer is the most prevalent cancer and the leading cause of cancer-related deaths among women in Eswatini, which reported the world’s highest cervical cancer incidence (95.9 per 100,000) and mortality (64.3 per 100,000) rates in 2022. Despite this significant burden, cervical cancer screening coverage was limited to 19% as per WHO’s 2019 report. This study assessed progress in cervical cancer screening prevalence and identified predictors of screening uptake among women aged 25-59 in Eswatini. Method: Data were obtained from the 2021 Eswatini Population-based HIV Impact Assessment Survey, a cross-sectional household survey designed to assess the coverage and impact of HIV services among individuals aged 15 years and older. In this study, women aged 25-59, the national target group for cervical cancer screening, were included. Survey weights were applied to adjust for the study design. Bivariate analyses identified factors associated with screening uptake, with significant variables (p < 0.05) entered into multivariate logistic regression models. Screening predictors were identified using stepwise backward elimination, with results reported as adjusted odds ratios (OR) and 95% confidence intervals (CI). Result: Among 3,193 women aged 25-59, the lifetime cervical cancer screening prevalence was 48.2%. HIV-positive women had significantly higher odds of screening compared to HIV-negative women (59% vs. 39%; OR=2.22, 95%CI:1.90-2.59). Women aged 36-45 were more likely to undergo screening than those aged 25-35 (OR=1.35, 95%CI: 1.12-1.62). Higher economic status (fourth vs. lowest wealth quintile) was associated with increased screening uptake (OR=1.41, 95% CI: 1.06-1.88). Conversely, lower odds of screening were observed among women with no formal education (OR=0.58, 95%CI: 0.41-0.84), no healthcare visits in the past 12 months (OR=0.67, 95% CI: 0.55-0.83), and no use of family planning services (OR=0.81, 95% CI: 0.68-0.96). Women with no sexual partners were also less likely to be screened compared to those with two or more partners (OR=0.08, 95% CI: 0.01-0.62). Although rural women had lower odds of screening than urban women, the difference was not statistically significant (OR=0.86, 95% CI: 0.70-1.05). Conclusion: While cervical cancer screening in Eswatini has shown significant progress, disparities persist among women with lower socioeconomic status, limited education, and fewer healthcare visits. Citation Format: Abenezer M. Tafese, Bikiltu D. Dirbaba, Meseker T. Fentie, Charnita Zeigler-Johnson. Bridging gaps in cervical cancer screening: Prevalence and key predictors among women aged 25-59 years in Eswatini [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4961.