Prevalence and factors associated with uptake of cervical cancer screening at primary care facilities in Trinidad: a cross-sectional study

Waly Mohan; Rohan G Maharaj; Raveed Khan; Syriah David; Sherrelle Davis; Brittany Deane; Thershus Chinapoo; Felice Cox; Reyann Cooper; Kristus David; Tiye Charles; Akilah Guevara

doi:10.1136/bmjph-2024-001297

Prevalence and factors associated with uptake of cervical cancer screening at primary care facilities in Trinidad: a cross-sectional study

BMJ Public Health. 2025 Jun 24;3(1):e001297. doi: 10.1136/bmjph-2024-001297. eCollection 2025.

Authors

Affiliations

¹ University of the West Indies, St Augustine, Trinidad and Tobago.
² Paraclinical Sciences, The University of the West Indies, Mt Hope, Trinidad and Tobago.

Abstract

Objectives: The use of the Papanicolaou (Pap) test for early detection of cervical carcinoma is well-established. This study determined the prevalence and factors associated with cervical cancer screening compared with nonscreening among women accessing primary care health centres in North-Central Trinidad.

Methods: A descriptive, cross-sectional study was conducted using a convenience sample of women between the ages of 21 and 65 years attending walk-in primary care clinics during the period February 2018 to July 2018. A total of 435 self-administered questionnaires were completed, which included both de novo and validated tools from previous cervical cancer research. The questionnaire was structured along the Health Belief Model. χ² analysis was used to determine differences and associations between categorical variables.

Results: 435 women were approached and 432 participated, yielding a response rate of 99.3%. Most of the participants fell into the 31-40-year age group (27.6%), 27.1% in the 21-30-year age group, 23.2% in the 41-49-year age group and 22.1% in the 50-65-year age group. The prevalence of screening for cervical cancer screening was found to be 63.3%. A significant association (p<0.05) was found between age and self-reported ethnicity with screening for cervical carcinoma. Barriers such as being embarrassed and perceived interference with sexual function were significantly associated with nonscreening (p<0.05).

Conclusion: This study revealed a higher than expected prevalence of cervical cancer screening among women attending select primary care facilities in North-Central Trinidad. This rate was well below the 80% target recommended by the Pan American Health Organization and WHO. As such, further work is required to improve perceptions, overcome barriers and strengthen primary healthcare delivery systems to enhance uptake of Pap smear screening.

Keywords: Community Health; Female; Mass Screening; Preventive Medicine; Public Health.