Public Health researchers advance World Health Organization goal of eliminating cervical cancer by 2030

Despite advances in screening, prevention and treatment, cervical cancer is the second-most prevalent cancer globally. Experts project that roughly 500,000 women—particularly those in developing countries—will die of cervical cancer each year by 2030. At the same time, women experiencing intimate partner violence may face additional challenges related to cervical cancer screening

Until now, however, research into associations between intimate partner violence and cervical cancer screening has been limited. New research from the Texas A&M University School of Public Health published in Women’s Health Reports adds to the knowledge base by analyzing factors that could influence whether women in the Philippines seek cervical cancer screening.

“The World Health Organization set targets for cervical cancer screening, human papillomavirus vaccination and cervical cancer treatment with an eye toward eliminating cervical cancer by 2030,” said Wah Wah Myint, DrPH, a researcher with the Center for Community Health and Aging who helped conduct the study. “Still, gaps in vaccination and screening persist in the Philippines, and further interventions may be needed.”

The team focused on Filipino women because this population has little access to cervical cancer screening even though this cancer is the second-most frequent cancer and fourth-leading cause of death among Filipino women. In addition, as of 2023, the Philippines had the lowest HPV first-dose coverage (26 percent) in Southeast Asia, in contrast to Cambodia (91 percent) and Indonesia (82 percent).

“Cervical cancer will persist in the Philippines unless these conditions change,” Myint said.

In the study, Myint and Sara Mendez, DrPH, together with colleagues from King Abdulaziz University in Saudi Arabia (Roaa Aggad, DrPH) and Clemson University (Qiping Fan, DrPH), analyzed data from a 2022 national health survey in the Philippines to get a better understanding of how intimate partner violence and other factors could interact with cervical cancer screening.

The researchers used data from the Philippines’ National Demographic and Health Survey, a comprehensive and nationally representative study of multiple measures of health, including cancer screening and intimate partner violence. The analysis involved 19,228 women who answered survey items about intimate partner violence. Myint and colleagues looked at whether each survey participant had ever had a cervical cancer screening along with data on types of intimate partner violence women had experienced. They also included additional data like age, urban or rural residence, educational attainment and employment as covariates.

“We found that more than 90 percent of the survey respondents had never had a cervical cancer screening and that around 17 percent of the women surveyed had experienced at least one type of intimate partner violence,” Myint said.

Analysis of intimate partner violence and cancer screening found that women in the survey who had experienced intimate partner violence had higher screening rates than the overall group. These higher rates could be due to higher perceived risks of cervical cancer by women who have experienced emotional intimate partner violence.

Myint and colleagues also found differences in screening rates relative to age, educational attainment and employment. Older women, women with more education and employed women all had higher rates of cervical cancer screening. In the Philippines, guidelines recommend starting cervical cancer screening at age 25, which could explain the age differences. Additionally the educational disparity points to a crucial need to develop interventions that inform women with lower education levels about the importance of cervical cancer screening.

The researchers note a few limitations to their analysis. For example, the data only cover a short timeframe, so it was impossible to determine causal relationships or changes over time. The data also were self-reported and thus subject to recall bias. The study also focused solely on screening, leaving out HPV vaccination and treatment. In addition, it was not possible to measure what participants knew about cervical cancer screening or their attitudes toward it.

“We believe this study could open the door to further research into the interaction between intimate partner violence and other factors and cervical cancer screening,” Myint said. “Making screening and information about it more accessible is critically important, especially for more vulnerable populations.”