Prevalence and Predictive Factors of Cervical Cancer Screening in Saudi Arabia: A Nationwide Study

Background: Cervical cancer, despite being preventable, is one of the most prevalent cancers among females globally and in Saudi Arabia. The literature demonstrated that, unlike global trends, cervical cancer incidence in Saudi Arabia is increasing. In addition to that, a high proportion of it is discovered in advanced stages. This state of late discovery was attributed to the absence of efficient preventive and screening programs. Observing the scale of the preventable morbidities and mortalities that can be caused by cervical cancer and the efforts and costs that are positioned to fight cervical cancer across the globe and the current ambiguity in the cervical cancer screening prevalence in Saudi Arabia brings the realization of the importance of conducting a study that properly explores the status of cervical cancer screening in Saudi Arabia. Aim: This study aims to measure the prevalence and the predictive factors for cervical cancer screening among adult women who were previously sexually active in Saudi Arabia, as well as explore the participants' knowledge and attitude toward cervical cancer and human papillomavirus (HPV) vaccines. Methods: This study was a nationwide cross-sectional study conducted in Saudi Arabia between September 2023 and November 2023 on adult Saudi females between the ages of 21 and 65 years who were previously sexually active and did not undergo a hysterectomy. Data were collected through a convenience sampling technique where a self-administered survey was established and disseminated to the targeted population all over the country with the assistance of data collectors. Cervical cancer screening prevalence and screening predictive factors were measured. Factors associated with cervical cancer screening and knowledge of cervical cancer were tested using a chi-square test, an independent t-test, and an ANOVA test. Multivariate logistic regression was also used to determine predictors of cervical cancer screening. Results: The study included 2,337 participants. The prevalence of cervical cancer screening among Saudi females was observed to be 22.1%. The most commonly reported reason for not undergoing cervical cancer screening was that it was never recommended by a physician, as reported by 42.4%. Only 7.6% reported taking the HPV vaccine. The majority of the participants (84.1%) had a low knowledge level about cervical cancer. The multivariate logistic regression model revealed that the following factors were observed to be significantly predictive of undergoing cervical cancer screening: being 46-59 years of age (74% increase rate), having an income greater than 20,000 Saudi Riyals (SRs) (158% increase rate), having a history of gynecological problems (152% increase rate), knowing someone who underwent cervical cancer screening (393% increase rate), and receiving a recommendation from a healthcare practitioner to undergo cervical cancer screening (1300% increase rate). Conclusion: There are clearly low rates of cervical cancer screening and even lower rates of uptake for the HPV vaccine, which are the prevention measures for cervical cancer. National initiatives and programs that promote HPV vaccine uptake and regular cervical cancer screening are highly recommended to minimize the morbidity and mortality of cervical cancer.