Determinants of Cervical Cancer Screening Utilization among Women of Reproductive Age in Choma District, Zambia.

Background: Cervical cancer is a significant global health challenge, ranking as the fourth most prevalent cancer and the fourth leading cause of cancer-related death among women worldwide. Zambia has one of the highest cervical cancer incidence and mortality rates due to under-utilization of cervical cancer screening services (CCSS). Objective: The study aimed to assess the determinants of cervical cancer screening utilization among women of reproductive age in Choma District, Southern Province, Zambia. Methods: A non-interventional, quantitative analytical cross-sectional study was conducted among 384 respondents using systematic random sampling techniques. Data was collected using a structured questionnaire and analyzed with SPSS version 26 using chi-square tests and binary logistic regression. Results: The largest group of participants were aged 26-36, making up 52.6% (202) of the total, with a screening rate of 68.8% (139). The average age was 30.9 years (±7.75 years). The study found a cervical cancer screening rate of 66.9% among participants. Employment was significantly associated with lower odds of CCS utilization (aOR = 0.62, 95% CI: 0.39 - 0.98, p = 0.041), while the provision of information by healthcare providers about CCS and prevention was significantly associated with higher odds (aOR = 1.60, 95% CI: 1.02 - 2.50, p = 0.040). The availability of CCS services showed a significant association (uOR = 1.77, 95% CI: 1.05 - 2.99, p = 0.031), but this became non-significant after adjustment (aOR = 1.67, 95% CI: 0.97 - 2.89, p = 0.064). Conclusion: The study found a 66.9% CCS rate, with employed women less likely to participate. Workplace-based screening programs and employer collaboration with health authorities are recommended to boost participation, along with promoting CCS awareness through wellness programs.