Association of Sociocultural Factors and Health Literacy Levels with Cervi-cal Cancer Early Detection Among Women in Reproductive-Age Couples in the Service Area of the Laosu Community Health Center in 2025

Abstract : Background: Cervical cancer remains a major cause of death among women, particularly in settings where early detection coverage is low. Objective: This study analyzed the association of sociocultural factors and health literacy with cervical cancer early detection among women in reproductive-age couples in the Laosu Community Health Center service area in 2025. Methods: This quantitative cross-sectional study involved 278 respondents selected using simple random sampling. Data were collected using a structured questionnaire and analyzed using partial least squares structural equation modeling (PLS-SEM) with SmartPLS 4 software. Results: Sociocultural factors had a significant positive effect on health literacy (β = 0.323; t = 4.539; p = 0.000) and early detection of cervical cancer (β = 0.112; t = 4.962; p = 0.000). Health literacy did not significantly affect early detection (β = -0.007; t = 0.351; p = 0.726) and did not mediate the relationship between sociocultural factors and early detection (β = -0.002; t = 0.325; p = 0.745). The R-square values were 0.104 for health literacy and 0.159 for early detection, indicating limited explanatory power. Only 21 respondents (7.55%) had undergone early detection, while 257 respondents (92.45%) had not. Conclusion: Early detection of cervical cancer remained very low. Sociocultural factors, particularly stigma and shame within the final measurement model, were more directly associated with screening behavior than health literacy. These findings indicate a knowledge-behavior gap and suggest that culturally sensitive interventions should accompany health literacy improvement to increase cervical cancer screening uptake.