Cervical Cancer Screening Uptake and Sociodemographic determinants among women aged 25 to 49 years in Tanzania: Results from the 2023 National STEPS Survey

Background: Sub Saharan Africa (SSA) accounts for over 20% of global cervical cancer cases, despite having only about 14% of the world’s female population. It is the leading cause of cancer-related deaths among women in Tanzania with the mortality rate of 42.7 per 100,000 women. Objective: The survey aimed to assess the proportion of eligible population with a history of ever screened for cervical cancer, using any of the available methods. Methods: The survey was a household-based study employing a three-stage cluster sampling design. The target population for the cervical cancer screening assessment included all women aged 18–69 years who were usual residents of the selected households. The Tanzania Population and Housing Census 2022 served as the sampling frame for the 2022/2023 STEPS survey. The estimated sample size was 4,320, with an actual sample of 3,565 participants, of whom 1,256 women aged 25–49 years responded to questions on cervical cancer screening. Demographic and behavioral data were collected electronically using the Open Data Kit (ODK)-based eSTEPS platform from September 2022 to September 2023. Chi-square tests and modified Poisson regression models were used to identify factors associated with cervical cancer screening uptake. Results: Most participants were married or cohabited (70.5%) and resided in rural areas (63.7%). Overall, 10.9% (95% CI: 7.8–15.0) of women reported ever being screened. Compared with women aged 25–29years, those aged 30–39 years (aPR=1.90; 95% CI:1.17–3.07) and 40–49 years (aPR= 2.50; 95% CI:1.53–4.09) had a significantly higher prevalence of screening. Women residing in urban areas were nearly twice as likely to have been screened as those living in rural areas (aPR=1.98; 95% CI: 1.43–2.73) and those from Southern Highlands demonstrated a higher prevalence of screening compared with those from Pemba (aPR=4.32; 95% CI:1.05–17.79). In addition, higher educational attainment was associated with increased screening prevalence, with women who had primary education being more likely to have been screened than those with no formal education (aPR=1.67; 95% CI:1.11–2.50). Conclusion: Cervical cancer screening uptake among women in this study was low, with significant disparities by age, residence, geographical zone, and educational attainment. These findings underscore the need for targeted interventions to increase screening coverage, particularly among younger women, rural populations, and those with lower education levels.