Abstract
BACKGROUND: Despite ongoing community awareness programmes in Tanzania, cervical cancer screening (CCS) uptake remains low, with only 10 to 29% of eligible women participating. Improving screening is essential to achieving Sustainable Development Goal 3, which targets reducing premature mortality from non-communicable diseases. This study explored recent changes in CCS awareness, knowledge, attitudes, and practices among women in urban Dar es Salaam. METHODS: A qualitative descriptive study was conducted in Kawe ward, Dar es Salaam. Twenty-six women aged ≥21 years were purposively sampled. Data were collected between January and February 2020 using in-depth, face-to-face interviews guided by open-ended questions. Interviews were audio-recorded, transcribed verbatim, translated, and analysed using five-step qualitative content analysis to develop codes, categories, subthemes, and themes. RESULTS: All participants had heard of cervical cancer and CCS, yet only 2 of 26 had ever been screened. Awareness was high, but most women demonstrated inadequate knowledge of cervical cancer causes, risk factors, symptoms, prevention, and screening guidelines. Major barriers to screening included absence of symptoms, limited knowledge, lack of health-seeking behaviour, time constraints, perceived costs, and long waiting times at screening sites. Despite these barriers, participants expressed strong positive attitudes toward CCS and showed readiness to undergo screening if services were accessible, affordable, and accompanied by adequate education. CONCLUSION: While awareness of cervical cancer is high, knowledge gaps persist and remain a major barrier to CCS uptake. Ongoing community awareness initiatives have increased recognition of the disease's severity but have not translated into improved screening practices. Strengthening educational content, expanding community-level outreach, reducing waiting times, and improving service accessibility are essential to increase CCS participation among urban women in Tanzania.