Impact of Access to Health Services on Early Detection of Cervical Cancer in Ecuadorian Women

Abstract

Cervical cancer is the second most common cancer among women worldwide, primarily affecting those between the ages of 20 and 69, second only to breast cancer. According to the World Health Organization, over 90% of new cervical cancer cases occur in low- and middle-income countries. In Ecuador, approximately 1,600 new cases are diagnosed each year. Research has identified several factors that influence a woman’s decision to undergo Pap smears, including her knowledge of the disease, presence of gynecological symptoms, and age (especially among women in their 20s and beyond).This study seeks to understand the perceptions of Ecuadorian women regarding the barriers that limit their access to Pap smear screening. Using data from a nationally representative sample of women aged 10 to 49, drawn from the National Health and Nutrition Survey (ENSANUT, 2018), we conducted descriptive statistical analyses to identify key trends. To ensure the reliability of our results, we tested for multicollinearity, heteroscedasticity, and autocorrelation. We then applied a binary logistic regression model and calculated Odds Ratios (OR) with 95% confidence intervals. The study’s findings indicate that the main obstacles to Pap smear participation are embarrassment, lack of information, fear, distance from healthcare facilities, and financial limitations. Notably, the analysis revealed strong correlations between low income and low education levels with reduced screening adherence, while no significant barriers were found among women with higher education. Other factors, such as age, income, employment status, and education, also played a role in influencing screening behavior. By understanding the biopsychosocial characteristics of women, government initiatives can be tailored to improve Pap smear participation, promoting early detection of cervical cancer in a way that aligns with women’s needs and comfort. Expanding research in this area is critical to addressing sexual health issues and enhancing both family and societal well-being.