Factors associated with awareness and uptake of breast and cervical cancer screening among Nepalese women: Evidence from Nepal demographic and health survey 2022

Objective To determine the factors associated with awareness and uptake of breast cancer screening (BCS) and cervical cancer screening (CCS) among Nepalese women aged 15-49 years. Methods We analyzed data from nationally representative Nepal demographic health survey 2022. We used weighted analysis to account for complex survey design of the survey. We presented categorical variables with frequency, percent (%) and 95% CI around percent. We used univariate and multivariable logistic regression to determine factors associated with awareness and uptake of BCS and CCS. The results of regression analysis were presented with crude odds ratio (COR) and adjusted odds ratio (AOR) and their 95% CI. Results The awareness and uptake of BCS among Nepalese women were 48.9% and 4.4% respectively whereas the awareness and uptake of CCS were 29.9% and 6.4% respectively among Nepalese women. The awareness of BCS and CCS were 1.10 and 1.22 times respectively among women with media exposure and 1.58 and 1.24 times among women with health insurance coverage. Compared to the poorest, the richest and richer have higher odds of being aware of BCS and CCS and have higher odds of BCS and CCS uptake. The uptake of CCS was 5.64 times higher among women who have heard about CCS and women who had heard about BCS had 7 times higher odds of BCS uptake. Conclusion Though awareness is relatively good, the uptake of BCS and CCS screening was very poor in Nepalese women. Provinces, ethnicity, age, education, wealth, marital status, employment, media exposure and health insurance coverage were identified as key factors associated with the awareness and uptake of BCS and CCS. These findings highlight the importance of considering socio-demographic factors in implementing effective cancer screening programs and targeting specific populations for increased awareness and uptake of screenings. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: We requested the DHS program for permission to use NDHS 2022 dataset which was granted to download and use NDHS 2022 dataset from . I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data can be downloaded after receiving approval from the DHS program ().