Abstract
BACKGROUND: Suboptimal screening for cervical cancer is found in remote areas. This study aims to evaluate the suboptimal screening prevalence and determine the factors associated with suboptimal cervical cancer screening among ethnic women in the Thailand-Myanmar border area. METHODS: This is a cross-sectional study conducted from July to December 2023. The eligible criteria were ethnic women aged 30-60 in Pai district, Mae Hong Son province in northern Thailand. Descriptive statistics were used to describe the characteristics, accessibility to health care service, knowledge, attitude and perceptions about Human Papillomavirus (HPV), cervical cancer and screening, and support for cervical cancer screening. The factors associated with suboptimal screening were determined using binary logistic regression. RESULTS: Among 354 ethnic women, one-fourth had suboptimal screening for cervical cancer. The positive attitude towards cervical cancer screening and the perceived risk of cervical cancer were high. Most of the participants had a medium level of knowledge about HPV and cervical cancer. Factors associated with suboptimal screening were younger age (adjusted Odds Ratios(aOR) = 1.48, 95% confidence interval (CI): 1.06-2.07), being Hmong ethnic group (aOR = 2.63, 95%CI: 1.30-5.34) compared to Karen ethnic group, and lack of information support from health care personnel (aOR = 1.88, 95%CI: 1.08-3.29) . Positive attitude toward the screening was associated with less suboptimal screening (aOR=0.56, 95%CI: 0.32-0.96). CONCLUSION: Information support from local health personnel plays an important role in health promotion and health literacy for cervical cancer screening in ethnic women as information and support to accommodate the languages and cultural can enhance engagement and trust.