Prevalence, Barriers, and Socio-Economic Determinants of Cervical Cancer Screening Among Women in Rwanda: A Nationwide Study

Background: Despite national efforts, cervical cancer screening participation remains critically low in Rwanda. This study assesses the prevalence, barriers, and socio-economic determinants of cervical cancer screening among Rwandan women. Methods: This cross-sectional study utilized data from the 2022 Rwanda Non-Communicable Diseases Risk Factors STEPS Survey. Data from a sample of 2,719 women aged 30-69 years were analyzed using descriptive statistics and Poisson regression to identify predictors of not undergoing cervical cancer screening. Results: Among women aged 30-69 years, 89.8% reported never undergoing cervical cancer screening. The most common barrier was lack of knowledge, with 52.2%, citing not knowing how or where to get tested, and lack of time reported by 12.6%. Regression results indicates that women aged 60-69 years were 5% more likely to have never screened compared to those aged 30-44 years (PR = 1.05, 95% CI: 1.01-1.09). Higher education levels were associated with increased screening uptake; women with primary school education (PR = 0.97, 95% CI: 0.94-0.99) and above primary level education (PR = 0.90, 95% CI: 0.82-0.98) were less likely to have never screened. Women in the Western province (PR = 1.11, 95% CI: 1.03-1.19) and rural areas (PR = 1.09, 95% CI: 1.03-1.16) were more likely to have never screened. Women in Income category E (no income) were less likely to have never screened compared to those in Category A or B [>49USD] (PR = 0.91, 95% CI: 0.84-0.99). Conclusion: The high prevalence of non-screening for cervical cancer underscores the need for enhanced health education and improved access to screening services in Rwanda, particularly for older women, those with lower education levels, higher incomes, and residents of rural areas and the Western province.