Knowledge, Attitudes and Barriers Towards Cervical Cancer Screening Among Women of Reproductive Age in Lower Manya Krobo Municipality, Eastern Region

Abstract

Background: Cervical cancer is a serious public health concern globally, with a disproportionately high burden in low- and middle-income countries, including Ghana. Despite the availability of effective screening methods, uptake remains low, particularly in peri-urban and rural settings. Limited knowledge, negative attitudes, and multiple sociocultural and health system barriers continue to hinder participation in screening programs. Understanding these factors at the Municipality level is essential for designing context-specific interventions. Aim: This study aimed to assess the knowledge, attitudes, and barriers towards cervical cancer screening among women of reproductive age in the Lower Manya Krobo Municipality, Eastern Region of Ghana. Methods: A quantitative cross-sectional study design was employed among 314 women aged 15–49 years. Data were collected using a structured interviewer-administered questionnaire. Descriptive statistics were used to summarize variables, while chi-square tests and logistic regression analyses were conducted to examine associations between independent variables and cervical cancer screening uptake. Statistical significance was set at p < 0.05. Results: Overall, 55.41% of respondents had good knowledge of cervical cancer and screening, while 44.59% had poor knowledge. Although 65.61% had heard of cervical cancer screening, awareness of specific screening methods was low, with 61.78% unable to identify any method. Attitudes towards screening were generally positive, with the majority agreeing that screening is necessary and expressing willingness to participate if services were free. However, screening uptake was low, with only 23.25% of respondents having ever undergone screening. The most commonly reported barriers were lack of knowledge about where screening services are provided (30.57%), not being informed about screening (28.66%), perceived lack of need due to absence of symptoms (27.71%), and fear of screening results (27.39%). Knowledge level was significantly associated with screening uptake (p < 0.001), while socio-demographic factors and attitudes were not statistically significant. Conclusion: Despite moderate levels of awareness and generally positive attitudes, cervical cancer screening uptake remains low among women in the Lower Manya Krobo Municipality. Knowledge gaps and informational barriers play a critical role in limiting screening participation. There is a need for targeted health education, improved dissemination of information on screening services, and community-based interventions to enhance screening uptake.