Perceived community cervical cancer prevention support and cervical cancer screening utilization among women in Shenzhen, China: a cross-sectional study.

PURPOSE: Community health services have the capacity to inform eligible women about cervical cancer prevention, recommend screening, and assist with access to care. Whether favorable perceptions of community support are associated with completed screening in an urban Chinese setting is unclear.

METHODS

We conducted a cross-sectional electronic survey of women recruited through more than 20 community health service centers affiliated with two hospitals in Shenzhen and through gynecology outpatient clinics. The source dataset comprised 3,277 completed questionnaires: 2,142 (65.4%) recruited through community health service centers, 853 (26.0%) through gynecology outpatient clinics, and 282 (8.6%) through community outreach events. The analysis included 3,033 women aged 18-65 years. The outcome was self-reported cervical cancer screening within the preceding 3 years. A six-item perceived community cervical cancer prevention-support score was evaluated using Cronbach's alpha and examined in multivariable logistic regression with sociodemographic and screening-related covariates.

RESULTS

Of 3,033 women, 1,314 (43.3%) reported screening within the preceding 3 years. The support scale had good internal consistency (Cronbach's alpha = 0.918; mean 3.79, SD 0.83). In this cross-sectional sample, the overall support score was not independently associated with completed screening after adjustment (aOR = 0.935, 95% CI 0.856-1.021; p = 0.135). Knowledge of screening methods was associated with prior screening (aOR = 1.184 per one-point increase, 95% CI 1.102-1.271; p < 0.001). In exploratory item-level analysis, expected appointment support for vaccination or screening was inversely associated with prior screening (aOR = 0.881, 95% CI 0.790-0.983; p = 0.023). In exploratory item-level analysis with Benjamini-Hochberg false discovery rate correction for multiple testing, no individual community support item remained statistically significant.

CONCLUSION

In this sample, favorable perceived community prevention support was not independently associated with completed cervical cancer screening. Future prospective studies that distinguish perceived support from documented service contacts, including invitations, bookings, attendance, result communication, and follow-up, are needed to evaluate whether active navigation pathways improve verified screening completion.