Breast and cervical cancer screening in a semi-urban African setting: evidence from Franceville, Gabon (2015–2021)

Background Breast and cervical cancers are among the most frequent malignancies in women worldwide and represent a growing public health concern in sub-Saharan Africa (SSA). In Gabon, national screening programs have been established, but their effectiveness remains poorly documented, particularly outside the capital city, Libreville. This study, therefore, aimed to describe the screening outcomes and associated factors for breast abnormalities and suspected cervical lesions at the Centre Hospitalier Universitaire Amissa Bongo (CHUAB) in Franceville, Gabon. Methods We conducted a retrospective cross-sectional study that included all women who attended routine screening at CHUAB between 2015 and, 2016 and, 2018 and 2021. Data were retrieved from hospital registries and medical records. All women underwent both clinical breast examination (CBE) and visual inspection with acetic acid (VIA). Sociodemographic, reproductive, and clinical variables were analyzed to determine their associations with screening outcomes using univariable and exploratory multivariable logistic regression models. Results A total of 1,328 women were included in the study, with a mean age of 35.4 ± 10.8 years. In univariable analysis, women aged 45–73 years had lower odds of cervical screening positivity compared with those aged 14–25 years (OR = 0.52, 95% CI: 0.29–0.90; p = 0.021). In exploratory multivariable analysis, non-Gabonese nationality and employment in the public sector were associated with cervical screening positivity. Regarding breast abnormalities, an age at first pregnancy between 30 and 39 years was associated with higher odds of screening positivity in univariable analysis (OR = 3.90, 95% CI: 1.07–11.4; p = 0.021); however, no factors remained statistically significant in the adjusted model. Conclusion This study offers one of the first accounts of routine breast and cervical cancer screening outcomes in a semi-urban setting in south-eastern Gabon. VIA and CBE detected a measurable proportion of women with suspected cervical lesions and breast abnormalities, underscoring the value of these simple and accessible screening approaches in resource-limited settings. Strengthening follow-up systems, improving data management, and expanding screening coverage could further enhance cancer control among women in Gabon.