Abstract
INTRODUCTION: Cervical cancer is one of the leading causes of cancer-related deaths in women globally, with most of the cases linked to Human Papilloma Virus (HPV). In Nepal, where over majority of the population resides in rural areas, women often face significant delays in accessing cervical cancer screening. This study aimed to examine the prevalence and factors influencing cervical cancer screening uptake among women aged 30–49 years in Bhanu Municipality, Tanahun. METHODS: A community-based cross-sectional study was conducted among 310 women aged 30–49 years between June and November 2023. Participants were selected using multistage sampling. Data were collected through face-to-face interviews. The Nepal Health Belief Model scales were used to assess perception-related factors. Bivariate and multivariate logistic regression analysis were performed to determine the factors associated with cervical cancer screening uptake. RESULTS: The prevalence of cervical cancer screening uptake among the surveyed women was 11.6%. Of the 310 respondents, 26.8% reported high susceptibility, 46.5% perceived high severity, 45.2% perceived high threat, 45.2% perceived high benefits, 60% perceived high barriers, 49.7% reported high self-efficacy, and 35.8% perceived high cues to action regarding cervical cancer screening. The primary reasons for not undergoing screening were lack of awareness (62.0%), had no health issues/fear of screening (53.6%), the belief that screening was unnecessary (46.3%), and lack of time (14.2%). Multivariate analysis indicated that gynecological examination history (AOR = 5.151, 95% CI = 2.191–12.113), perceived barriers (AOR = 7.945, 95% CI = 3.091–20.423), and cues to action (AOR = 3.974, 95% CI = 1.742–9.065) were significantly associated with cervical cancer screening uptake. CONCLUSION: Cervical cancer screening uptake among women in Bhanu Municipality was very low and was primarily influenced by history of gynecological examination, perceived barriers, and limited cues to action. Engaging Female Community Health Volunteers (FCHVs) for door-to-door counseling, reducing barriers, and improving accessibility of services are critical to increasing cervical cancer screening uptake. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12905-026-04360-y.