Knowledge and attitude toward cervical cancer screening among women aged 30-49 years attending selected health facilities in Ethiopia: Using structural equation model

Background: According to estimates, there were 570,000 new cases of cervical cancer in 2018, making it the fourth most common malignancy among women worldwide. Almost all 342,000 deaths from cervical cancer take place in low- and middle-income countries, accounting for 90 % of deaths. Few studies use structural equation modeling to comprehensively analyze the predictors of cervical cancer screening. Objective: The purpose of this study was to assess knowledge and attitude towards cervical cancer screening and its associated factors among women aged 30-49 years in Ethiopia. Methods: A facility-based cross-sectional study was conducted among eligible women attending health centers in Oromia and the southern nationality People regions. A systematic random sampling method was used to select 916 respondents. The data was collected using a structured interviewer-administered questionnaire. Structural equation modelling was employed to assess the direct and indirect relationship between knowledge and attitude toward cervical cancer screening. Results: The overall proportion of knowledge and attitude towards cervical cancer detection among women 30-49 years of age were 28 % and 57 %, respectively., income (adjusted fl = 0.075, 95 % CI: 0.042, 0.091), being urban (adjusted fl = 0.088, 95 % CI: 0.062, 0.093), being employee (adjusted fl = 0.119, 95 % CI: 0.113, 0.342), the number of parity (adjusted fl = 0.014, 95 % CI: 0.012, 0.021), usage of contraceptive (adjusted fl = 0.719, 95 % CI: 0.057, 0.082) and family history of cervical cancer (adjusted fl = 0.211, 95 % CI: 0.18, 0.302) were statistically significant associated factors with knowledge and Being smoker (adjusted fl = -0.157, 95 % CI: 0.265, -0.141). Having multiple sexual partnership (adjusted fl = 0.169, 95 % CI: 0.148, 0.349), having formal education (adjusted fl = 0.118, 95 % CI: 0.052, 0.294), live in urban area (adjusted fl = 0.116, 95 % CI: 0.023, 0.347), knowledge (adjusted fl = 0.42, 95 % CI: 0.301, 0.567) were statistically significant associated factors with the attitude of women toward cervical cancer screening.