title: Utilization of cervical cancer screening services and its associated factors among primary school teachers in Ilala Municipality, Dar es Salaam, Tanzania.
abstract: BACKGROUND
  Worldwide cervical cancer is one of the more common forms of carcinoma among women, causing high morbidity and high mortality. Despite being a major health problem in Tanzania, screening services for cervical cancer are very limited, and uptake of those services is low. We therefore conducted a study to investigate utilization of cancer screening services, and its associated factors among female primary school teachers in Ilala Municipality, Dar es Salaam.
  
  
  METHODS
  We conducted a cross-sectional study between May - August 2011 which involved 110 primary schools in Ilala Municipality in Dar es Salaam. Five hundred and twelve female primary school teachers were sampled using a two-stage cluster sampling procedure. Data on utilization of cervical cancer and risk factors were collected using a self-administered questionnaire. Proportional utilization of cervical cancer screening services was identified through a self report. Risk factors for services utilization were assessed using logistic regression analyses.
  
  
  RESULTS
  Out of 512 female primary school teachers, only 108 (21 %) reported to ever been screened for cervical cancer. Utilization of cervical cancer screening services was 28 % among those aged 20-29, 22 % among married and 24 % among those with higher level of education. Women were more likely to utilize the cancer-screening service if they were multiparous (age-adjusted OR = 3.05, 95 % CI 1.15-8.06, P value 0.025), or reported more than one lifetime sexual partner (age-adjusted OR 2.17, 95 % CI 1.04-4.54, P value 0.038), or did not involve their spouse in making health decisions (adjusted OR 3.56, 95 % CI 2.05-6.18, P value <0.001).
  
  
  CONCLUSIONS
  The study has demonstrated low level of utilization of cervical cancer screening service among female primary school teachers in Ilala munipality. Female primary school teachers with more than one previous pregnancy and those with more than one life-time sex partners were more likely to report utilization of the service. Spouse or partners support was an important factor in the utilization of cervical cancer screening service amongst the study population.
authors.affiliation: World Health Organization, Tanzania Country Office, P O Box 9292, Dar es Salaam, Tanzania. kileon@who.int.
authors.forename: Neema Minja
authors.initials: NM
authors.lastname: Kileo
authors.affiliation: National Institute for Medical Research, Mwanza Medical Research Center, P O Box 1452, Mwanza, Tanzania. dennamichael@gmail.com.
authors.forename: Denna
authors.initials: D
authors.lastname: Michael
authors.affiliation: National Institute for Medical Research, Mwanza Medical Research Center, P O Box 1452, Mwanza, Tanzania. nyasule.neke@gmail.com.
authors.forename: Nyasule Majura
authors.initials: NM
authors.lastname: Neke
authors.affiliation: Muhimbili University of Health and Allied Sciences (MUHAS), P O Box 67005, Dar Es Salaam, Tanzania. cmoshiro@yahoo.com.
authors.forename: Candida
authors.initials: C
authors.lastname: Moshiro
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D005178:Faculty; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D012307:Risk Factors; D012574:Schools; D057566:Self Report; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control