Exploring Factors Influencing Cervical Cancer Screening Participation among Singaporean Women: A Social Ecological Approach

Background/Objectives: Cervical cancer screening uptake in Singapore remains suboptimal. This study employed the Social Ecological Model (SEM) to investigate factors influencing cervical cancer screening participation among Singaporean women. Methods: The study included 665 women, aged 25-69 years, who reported awareness of cancer screening and no personal cancer history. Data were collected through a previously described online survey. Hierarchical logistic regression analysis was conducted to identify significant factors influencing screening participation. Results: Only 30% of participants reported cervical cancer screening participation. Women aged 25-29 years (OR = 0.33; 95% CI = 0.12-0.77), Malay women (OR = 0.42; 95% CI = 0.20-0.83), and unmarried women (OR = 0.30; 95% CI = 0.18-0.48) were less likely to be screened. Positive associations with screening participation were observed with good cervical cancer screening knowledge (OR = 2.90; 95% CI = 1.96-4.32), awareness of primary care providers' role in delivering screening services (OR = 1.94; 95% CI = 1.24-3.10), cancer information seeking behavior (OR = 1.59; 95% CI = 1.07-2.39), and acceptance of self-sampling options (OR = 1.81; 95% CI = 1.22-2.70). Conclusions: Our study highlights the cumulative impact of factors at various SEM levels on screening participation and underscores the necessity for more targeted and multi-pronged strategies to improve cervical cancer screening uptake in Singapore.