Write a PREreview

Background: Cervical cancer remains a major public health in sub-Saharan Africa, despite the availability of effective screening methods. In Cameroon, screening coverage remains low, largely due to several factors. The COVID-19 pandemic further exacerbated these challenges. However, the magnitude of the COVID-19 pandemic impact, remains poorly documented in the Cameroonian context. Understanding the interplay between all, is therefore essential to guide targeted interventions aimed at improving cervical cancer screening coverage and achieving global elimination targets. Methodology: A mixed observational analytic study combining a cross-sectional survey with a retrospective trend reconstruction, was undertaken from January 2016 to December 2024, in five regions of Cameroon: The Centre, South, North, Far North, and Littoral regions. A total of 3751 women ages between 25 and 65 years agreed to participate and were interviewed with semi-structured questionnaires, as well as health care workers, service providers, and health professionals. The data collected, captured access to screening services, perceived socio-economic and environmental barriers, and actual use of cytological and HPV tests. Results: A low screening uptake were observed. The non-use of services was significantly related to living in rural locations (OR=0.55, p=0.001), low education attainment (OR=1 for none, OR=1.45 for higher education, p=0.003), and lower social coverage (OR=1 for uninsured, OR = 2.30 for insured, p=0.001). The top barriers to accessing services reported by participants were cost, distance to services, and poor information providing (all p=0.001). Conclusion: all these barriers inhibit the early diagnosis of cervical cancer in Cameroon. COVID-19 pandemic plays a crucial role in reducing availability of screening programs and decreased healthcare utilization by women due to fear of infection and movement restrictions