Importance The World Health Organization is developing a global strategy to eliminate cervical cancer, with goals for screening prevalence among women aged 30 through 49 years. However, evidence on prevalence levels of cervical cancer screening in low- and middle-income countries (LMICs) is sparse. Objective To determine lifetime cervical cancer screening prevalence in LMICs and its variation across and within world regions and countries. Design, Setting, and Participants Analysis of cross-sectional nationally representative household surveys carried out in 55 LMICs from 2005 through 2018. The median response rate across surveys was 93.8% (range, 64.0%-99.3%). The population-based sample consisted of 1 136 289 women aged 15 years or older, of whom 6885 (0.6%) had missing information for the survey question on cervical cancer screening. Exposures World region, country; countries' economic, social, and health system characteristics; and individuals' sociodemographic characteristics. Main Outcomes and Measures Self-report of having ever had a screening test for cervical cancer. Results Of the 1 129 404 women included in the analysis, 542 475 were aged 30 through 49 years. A country-level median of 43.6% (interquartile range [IQR], 13.9%-77.3%; range, 0.3%-97.4%) of women aged 30 through 49 years self-reported to have ever been screened, with countries in Latin America and the Caribbean having the highest prevalence (country-level median, 84.6%; IQR, 65.7%-91.1%; range, 11.7%-97.4%) and those in sub-Saharan Africa the lowest prevalence (country-level median, 16.9%; IQR, 3.7%-31.0%; range, 0.9%-50.8%). There was large variation in the self-reported lifetime prevalence of cervical cancer screening among countries within regions and among countries with similar levels of per capita gross domestic product and total health expenditure. Within countries, women who lived in rural areas, had low educational attainment, or had low household wealth were generally least likely to self-report ever having been screened. Conclusions and Relevance In this cross-sectional study of data collected in 55 low- and middle-income countries from 2005 through 2018, there was wide variation between countries in the self-reported lifetime prevalence of cervical cancer screening. However, the median prevalence was only 44%, supporting the need to increase the rate of screening.

中文翻译：

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55 个低收入和中等收入国家宫颈癌筛查的终生患病率


重要性 世界卫生组织正在制定消除宫颈癌的全球战略，目标是筛查 30 至 49 岁女性的宫颈癌患病率。然而，有关低收入和中等收入国家 (LMIC) 宫颈癌筛查患病率的证据很少。目的 确定中低收入国家终生宫颈癌筛查患病率及其在世界各地区和国家之间和内部的变化。设计、设置和参与者 对 2005 年至 2018 年在 55 个中低收入国家进行的具有全国代表性的横断面家庭调查进行分析。各项调查的中位答复率为 93.8%（范围为 64.0%-99.3%）。基于人群的样本包括 1 136 289 名 15 岁或以上的女性，其中 6885 名（0.6%）在宫颈癌筛查的调查问题中缺少信息。曝光世界地区、国家；国家的经济、社会和卫生系统特征；以及个人的社会人口特征。主要结果和措施 自我报告曾经做过宫颈癌筛查测试。结果 在参与分析的 1 129 404 名女性中，有 542 475 名年龄在 30 岁至 49 岁之间。拉丁美洲国家中，30 至 49 岁女性中，自我报告曾经接受过筛查的国家中位数为 43.6%（四分位距 [IQR]，13.9%-77.3%；范围，0.3%-97.4%）加勒比地区的患病率最高（国家级中位数，84.6%；IQR，65.7%-91.1%；范围，11.7%-97.4%），撒哈拉以南非洲地区的患病率最低（国家级中位数，16.9%） IQR，3.7%-31.0%；范围，0.9%-50.8%)。 区域内国家之间以及人均国内生产总值和卫生总支出水平相似的国家之间自我报告的终生宫颈癌筛查患病率存在​​很大差异。在国家内部，生活在农村地区、教育程度较低或家庭财富较低的妇女通常最不可能自我报告接受过筛查。结论和相关性 在这项对 2005 年至 2018 年 55 个低收入和中等收入国家收集的数据进行的横断面研究中，各国之间自我报告的终生宫颈癌筛查患病率存在​​很大差异。然而，中位患病率仅为 44%，表明需要提高筛查率。