Clinicopathologic characteristics and predictors of treatment uptake among patients with cervical cancer managed at Jimma University Medical Center, Southwest Ethiopia.

backgroundCervical cancer remains a major public health concern in Ethiopia because of limited screening and delayed diagnosis, resulting in high mortality. Most patients present with advanced-stage disease, predominantly squamous cell carcinoma. Despite the World Health Organization’s 90%–70%–90% strategy, screening coverage is low, and access to treatment remains inadequate. This study assessed the clinicopathologic characteristics and predictors of treatment uptake among cervical cancer patients managed at Jimma University Medical Center in southwest Ethiopia to inform evidence-based interventions.

methodsA cross-sectional study was conducted at Jimma University Medical Center, including all women with histologically confirmed cervical cancer between April 2019 and October 2024. Data on demographics, clinical presentation, pathology, and outcomes were collected using a pretested tool and entered into REDCap. Missing outcome data were supplemented through telephone interviews. Multiple imputation was used for missing explanatory variables (n = 20 datasets). Statistical analysis was performed using STATA version 17, univariable and multivariable logistic regression to identify predictors of treatment uptake.

resultAmong the 719 women with cervical cancer, most were illiterate, grand multiparous, and from rural areas. Postmenopausal bleeding and pelvic pain were the most common presenting symptoms. Over two-thirds experienced delays in seeking care exceeding 90 days, and only 16% had a history of prior cervical cancer screening. Of the 709 patients with documented stage, 78.4% presented with advanced disease (stage IIB–IV)), while 21.6% were diagnosed at an early stage (stage I–IIA). Chemoradiotherapy was the main treatment modality, while surgery was rarely performed. Treatment uptake was higher among women younger than 55 years (OR = 2.27; 95% CI: 1.08–4.75) and those with formal education (OR = 3.31; 95% CI: 1.25–8.70), whereas women diagnosed at stage IV were significantly less likely to receive treatment (OR = 0.10; 95% CI: 0.03–0.43).

conclusionThese findings underscore the need to strengthen culturally appropriate community awareness and expand accessible screening programmes, particularly in rural areas, to improve timely treatment and outcomes for women in middle age. Vaccination and palliative care services should also be integrated into comprehensive cervical cancer care.