Determinants of Precancerous Cervical Lesions Among Women Screened for Cervical Cancer at Adama Public Health Facilities, Adama, Ethiopia

<i>Introduction:</i> Precancerous cervical lesion is the potential risk factors of invasive cervical cancer. However, factors associated with premalignant cervical lesions remain poorly documented in general population in Adama town. The previous studies had their own methodological gaps which lead to generalizability limitations. Therefore, it is critical to identify the associated factors with precancerous cervical lesions for comprehensive and integrated screening services. <i>Objective:</i> To identify the determinants of precancerous cervical lesions among women screened for cervical cancer at Adama town public health facilities Adama, Oromia, Ethiopia, 2024. <i>Method:</i> Health facility based unmatched case control study design was carried out in selected public health facilities in Adama town. The public health facility participants were selected through simple random sampling techniques. The sample size of cases 84 and control 252 were collected by systematic random sampling. The data were entered and analyzed with Epi info 7.2.6 and SPSS 27. Variables with P-value < 0.25 in the binary logistic analysis were included in the multivariate logistic regression model. An odds ratio with its 95% CI and P value less than 0.05 was used to decide about the presence of association. <i>Result: </i>The median age of the participants was 36 years ± 8 IQR years. This study revealed that the odds of being positive for precancerous cervical lesion were higher among women who were widowed (AOR =10.679, 95% confidence interval CI: 3.049-37.405), with lower family income (AOR =4.662: 95% CI: 1.767-12.302), youngest first marriage age (AOR =5.005: 95% CI: 1.847-13.563), practicing sexual intercourse before age 16 (AOR =11.190: 95% CI: 1.280- 97.867), history of STIs (AOR =5.188: 95% CI: 1.689-15.934), partner history of STIs (AOR=5.324: 95% CI (1.521-18.630) and lifetime multiple sexual partners history (AOR=3.389: 95% CI: 1.438-7.987). <i>Conclusion:</i> Most of the determinants of precancerous cervical lesions were modifiable and mainly related to women’s socio-demographic related factors, reproductive, clinical and sexual behavior related. Therefore, strengthening awareness on safe sexual practices and healthy life styles through behavioral change communication would decrease the incidence of precancerous cervical lesions.