Factors Associated with Cervical Cancer Screening Service Utilization Among At-Risk Women in La-ai Subdistrict, Chawang District, Nakhon Si Thammarat Province

Abstract

This cross-sectional survey research aimed to study the factors associated with cervical cancer screening service utilization among at-risk women in La-ai Subdistrict, Chawang District, Nakhon Si Thammarat Province. The sample consisted of 418 at-risk women aged 30-60 years, selected through systematic sampling. The data collection instrument was a questionnaire developed by the researcher based on a literature review and the PRECEDE-PROCEED Model. The questionnaire included personal information, predisposing factors, enabling factors, and reinforcing factors related to cervical cancer screening service utilization. Data were analyzed using descriptive statistics and multiple logistic regression.

The study found that among predisposing factors, a high level of perceived susceptibility and benefits of cervical cancer screening was observed, while perceived severity of the disease and perceived barriers to screening were low. For reinforcing factors, social support was generally low, whereas enabling factors such as access to health information were mostly high. After controlling for variables, women aged 45 years or older were 1.65 times more likely to undergo screening than those aged 44 or younger. Women with an associate degree or vocational certificate were 64% less likely to be screened compared to those with primary education, and those working as vendors had a 70% lower likelihood of screening compared to government officers or state enterprise employees. Interestingly, women with a high perception of susceptibility were 46% less likely to undergo screening, whereas those with a high perception of screening benefits were 1.60 times more likely to be screened. These findings suggest the need for health personnel to provide more education on the risks and benefits of cervical cancer screening and to develop proactive screening strategies using village health volunteers (VHVs) as intermediaries to reach the target population.