A Bayesian Logistic Regression Approach to Investigating the Determinants Associated with Never Having Been Screened for Cervical Cancer Amongst Child-Bearing-Age Women in Jordan

TL;DR

This study identifies factors linked to low cervical cancer screening rates among Jordanian women of child-bearing age, highlighting the need for targeted interventions.

Contribution

The study uses Bayesian logistic regression to analyze determinants of cervical cancer screening non-participation in Jordan.

Findings

The prevalence of not being screened for cervical cancer was 83.8% among Jordanian women aged 15–49.

Key determinants included age, education, nationality, wealth, and marital status.

The study suggests community awareness and policy interventions could improve screening rates.

Abstract

Cervical cancer continues to be a major global public health problem, with 661,021 estimated new cases and 348,189 deaths reported in 2022. Approximately 53% of women in Jordan reported not being screened for CC in recent years. This study aimed to investigate the determinants associated with not being screened for CC amongst Jordanian women of child-bearing age. This was a cross-sectional study derived from the 2023 Jordanian Demographic Health Survey (JDHS) with 12,580 women aged 15–49 years. The study employed a non-informative Bayesian binary logistic regression approach to identify the factors that are associated with not being screened for CC. Results showed that the prevalence of not being screened for CC was 83.8% (95% CI: 83.3–84.3). The determinants identified in this study were women’s age group (OR = 0.46; 95% CI: 0.34–0.62), education level (OR = 0.56; 95% CI: 0.34–0.91), smoking status (OR = 0.75; 95% CI: 0.63–0.91), women’s nationality (OR = 4.30; 95% CI: 1.03–27.74), breastfeeding status (OR = 1.64; 95% CI: 1.31–2.07), wealth index (OR = 0.61; 95% CI: 0.53–0.71), self-reported health status (OR = 0.74; 95% CI: 0.64–0.87), marital status (OR = 1.45; 95% CI: 1.08–1.96), and HIV testing status (OR = 0.55; 95% CI: 0.40–0.75). The prevalence of not being screened for CC amongst Jordanian women of child-bearing age was found to be very high: a red flag for attention. There is a need for interventions such as community awareness campaigns and education programmes focusing on women younger than 25 years, especially women living in rural and underserved areas. Additionally, incorporating policy interventions into public health facilities and having easy accessibility to tools or screening tests may improve rates of CC screening, and thus reduce the prevalence of CC.