Determinants of VIA Screening Utilization: A Cross-Sectional Logistic Regression Study in an Archipelagic Setting of Eastern Indonesia

Authors

  • Lidya Rumaketty Doctoral Student, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Apik Indarty Moedjiono Department of Biostatistics and Population Studies, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Masni Department of Population and Family Planning, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Aminuddin Syam Department of Nutrition, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Shanti Riskiyani Department of Health Promotion and Behavioral Sciences, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
  • Yahya Department of Anthropology, Faculty of Social and Political Sciences, Hasanuddin University, Makassar, Indonesia

DOI:

https://doi.org/10.6000/1929-6029.2026.15.19

Keywords:

Cervical cancer screening, visual inspection with acetic acid (VIA), contraceptive use, reproductive factors, women of reproductive age, cross-sectional study

Abstract

Background: Cervical cancer remains a leading cause of morbidity and mortality among women in low- and middle-income countries. Visual Inspection with Acetic Acid (VIA) is recommended as an effective and affordable screening method; however, coverage remains low in archipelagic regions of Eastern Indonesia.

Objective: To examine the association between reproductive factors and contraceptive use with VIA screening utilization among women of reproductive age.

Methods: A cross-sectional study was conducted among 131 women at a primary healthcare center in Ambon City. Data were analyzed using chi-square tests and multivariable logistic regression to estimate crude and adjusted odds ratios. Variables with p < 0.25 were included in the multivariable model. Model fit was assessed using the Hosmer–Lemeshow test, and explanatory power using Nagelkerke R².

Results: A total of 65.6% of respondents had undergone VIA screening. No variables were significantly associated with screening utilization (p > 0.05). Contraceptive use showed a non-significant tendency toward increased screening likelihood (AOR = 1.837; 95% CI: 0.443–7.610). The model demonstrated weak explanatory power (Nagelkerke R² = 0.05), and the omnibus test was not statistically significant (p > 0.05), indicating limited predictive capacity.

Conclusion: The study did not identify significant predictors of VIA utilization. The findings suggest that the variables included in the model were insufficient to explain screening behavior. Further studies with larger samples and more comprehensive analytical models are needed.

References

Bruni L, Albero G, Serrano B, Mena M, Collado J, Gómez D. Human Papillomavirus and Related Diseases in China. Summary Report. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre) 2021; 2023.

Denny L, Kuhn L, De Souza M, Pollack AE, Dupree W, Wright TC. Screen-and-treat approaches for cervical cancer prevention in low-resource settings: a randomized controlled trial. JAMA 2005; 294(17): 2173-81. DOI: https://doi.org/10.1001/jama.294.17.2173

Wang Y-Q, Zhang H-H, Liu C-L, Xia Q, Wu H, Yu X-H, et al. Correlation between auto-antibodies to survivin and MUC1 variable number tandem repeats in colorectal cancer. Asian Pacific J Cancer Prev 2012; 13(11): 5557-62. DOI: https://doi.org/10.7314/APJCP.2012.13.11.5557

Zhang G, Lang J, Shen K, Zhu L, Xiang Y. High‐risk human papillomavirus infection clearance following conization among patients with cervical intraepithelial neoplasm grade 3 aged at least 45 years. Int J Gynecol Obstet 2017; 136(1): 47-52. DOI: https://doi.org/10.1002/ijgo.12000

Greenland S, Senn SJ, Rothman KJ, Carlin JB, Poole C, Goodman SN, et al. Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations. Eur J Epidemiol 2016; 31(4): 337-50. DOI: https://doi.org/10.1007/s10654-016-0149-3

Everett T, Bryant A, Griffin MF, Martin‐Hirsch PPL, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane database Syst Rev 2011; (5). DOI: https://doi.org/10.1002/14651858.CD002834.pub2

Marlow LAV, Chorley AJ, Haddrell J, Ferrer R, Waller J. Understanding the heterogeneity of cervical cancer screening non-participants: data from a national sample of British women. Eur J Cancer 2017; 80: 30-8. DOI: https://doi.org/10.1016/j.ejca.2017.04.017

Taplin SH, Yabroff KR, Zapka J. A multilevel research perspective on cancer care delivery: the example of follow-up to an abnormal mammogram. Cancer Epidemiol Biomarkers Prev 2012; 21(10): 1709-15. DOI: https://doi.org/10.1158/1055-9965.EPI-12-0265

Musa J, Achenbach CJ, Dwyer LCO, Evans CT, Mchugh M, Hou L, et al. Effect of cervical cancer education and provider recommendation for screening on screening rates : A Systematic Review and Meta-Analysis 2017; 1-28. DOI: https://doi.org/10.1371/journal.pone.0183924

Moore SA, Cooper JM, Malloy J, Lyon AR. Core Components and Implementation Determinants of Multilevel Service Delivery Frameworks Across Child Mental Health Service Settings. Adm Policy Ment Health 2024; 51(2): 172-95. DOI: https://doi.org/10.1007/s10488-023-01320-8

Idowu A, Olowookere SA, Fagbemi AT, Ogunlaja OA. Determinants of Cervical Cancer Screening Uptake among Women in Ilorin, North Central Nigeria : A Community-Based Study 2016; 2016(Vili). DOI: https://doi.org/10.1155/2016/6469240

Indrawati F, Dhani WR. Determinants of the Regularity of Cervical Cancer Screening among Women in Semarang, Indonesia 2025; (34): 286-93.

Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Heal 2020; 8(2): e191-203. DOI: https://doi.org/10.1016/S2214-109X(19)30482-6

Zapata LB, Pazol K, Rollison JM, Loyola Briceno AC. Family Planning Reminder Systems: An Updated Systematic Review. Am J Prev Med 2018; 55(5): 716-24. DOI: https://doi.org/10.1016/j.amepre.2018.07.009

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021; 71(3): 209-49. DOI: https://doi.org/10.3322/caac.21660

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Published

2026-05-19

How to Cite

Rumaketty, L. ., Moedjiono, A. I. ., Masni, Syam, A. ., Riskiyani, S. ., & Yahya. (2026). Determinants of VIA Screening Utilization: A Cross-Sectional Logistic Regression Study in an Archipelagic Setting of Eastern Indonesia. International Journal of Statistics in Medical Research, 15, 208–215. https://doi.org/10.6000/1929-6029.2026.15.19

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