Cervical cancer awareness and screening practices among female students at makerere university main campus between the age of 18-45 years

Abstract

Cervical cancer remains a major public health burden in Uganda, with over 6,959 new cases and 4,607 deaths annually, despite being largely preventable through early detection and timely treatment. This study assessed awareness and screening practices regarding cervical cancer among 434 female students aged 18–45 years at Makerere University Main Campus. A descriptive cross-sectional design was employed, utilizing a structured self-administered questionnaire. Data were analysed using Stata 15, employing descriptive statistics and binary logistic regression to identify predictors of screening behavior. Findings revealed that 75.1% of participants had heard of cervical cancer, but detailed knowledge was limited only 25.2% who identified HPV as the main cause. Regarding symptoms, irregular vaginal bleeding (27.9%) and abnormal discharge (25.9%) were the most recognized, while only 16.3% mentioned postcoital bleeding. Awareness of prevention methods was moderately high at 60.4%, yet only 42.6% of the students had ever been screened, indicating a gap between awareness and practice. Binary logistic regression identified three statistically significant predictors of cervical cancer screening uptake. Cultural or social beliefs were positively associated with screening (OR = 3.07, SE = 0.93, p < 0.05), suggesting students with favourable perceptions were three times more likely to be screened. Conversely, lack of family or peer support (OR = 0.08, SE = 0.04, p < 0.05) and high cost of screening services (OR = 0.31, SE = 0.09, p < 0.05) significantly reduced the likelihood of screening. Knowledge about cervical cancer, while important (OR = 1.55, SE = 0.36), was marginally non-significant (p= 0.06), and accessibility to services was not a significant factor (p = 0.47). The study concluded that although general awareness of cervical cancer is fair among female students, critical knowledge gaps and socio-cultural and financial barriers persist. To bridge the awareness-practice gap, the following recommendations are proposed: (1) Strengthen university-based health education on HPV, screening procedures, and early signs of cervical cancer; (2) Subsidize or fully fund cervical screening services on campus to reduce financial constraints; (3) Launch peer-led sensitization programs to boost support systems; and (4) Involve cultural and religious leaders in destigmatizing screening practices. These interventions are essential to improving screening uptake and ultimately reducing the cervical cancer burden among young women in Uganda.