Determinants of non-utilization of cryotherapy among cervical cancer screening-positive women in public health facilities of West Shoa Zone, Oromia, Ethiopia: An unmatched case-control study.
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OBJECTIVE: Cervical cancer is largely preventable through vaccination, screening, early detection, and treatment of precancerous lesions. Cryotherapy is a simple, effective, and affordable treatment, particularly in low-resource settings. However, some women who screen positive do not receive recommended treatment. Evidence on factors associated with non-utilization of cryotherapy in Ethiopia is limited. The present study identified factors associated with non-utilization among women who screened positive for cervical precancerous lesions in public health facilities in West Shoa Zone, Oromia, Ethiopia. METHODS: A facility-based unmatched case-control study was conducted from September 1 to November 30, 2022. Cases were screening-positive women who did not receive cryotherapy, while controls were screening-positive women who received cryotherapy. A total of 297 women (74 cases and 223 controls) participated. Data were collected using a pretested interviewer-administered questionnaire and analyzed using SPSS version 26. Multivariable logistic regression was used to identify factors associated with non-utilization. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated. RESULTS: Non-utilization was significantly associated with being single (aOR = 3.06, 95% CI: 1.12-8.45), no formal education (aOR = 6.70, 95% CI: 2.40-18.72), fewer than three children (aOR = 6.10, 95% CI: 2.38-15.63), poor knowledge (aOR = 5.16, 95% CI: 1.98-13.31), unfavorable attitudes (aOR = 2.78, 95% CI: 1.13-6.83), inadequate counseling (aOR = 2.96, 95% CI: 1.41-6.33), and dissatisfaction with screening (aOR = 4.51, 95% CI: 2.03-10.05). CONCLUSION: Strengthening counseling, health education, and screening services may reduce non-utilization of cryotherapy among women with positive screening results.