Trends and disparities in cervical cancer screening prevalence in Vietnam: Evidence from the 2015 and 2021 WHO STEPS surveys

Abstract

Background Cervical cancer remains a significant public health concern. In Vietnam, national strategies have been introduced to increase screening coverage, but population-level data assessing progress remain limited. This study aimed to estimate cervical cancer screening prevalence and trends in Vietnam and identify associated demographic and socioeconomic factors using nationally representative data. Methods We conducted a secondary analysis of the 2015 and 2021 Vietnam WHO STEPwise Approach to Surveillance (STEPS) surveys. Cervical cancer screening prevalence was defined as self-reported history of ever screening via Pap smear, VIA, VILI, or HPV testing. Survey-weighted methods were used to estimate prevalence and assess changes over time. Temporal trends were evaluated using the Cochran-Armitage test. Multivariable survey-weighted logistic regression models were applied to identify associated factors. Results Among 4168 women, the overall screening prevalence was 20.47%, decreasing from 24.86% in 2015–16.36% in 2021 (p ' 0.001). Screening was more likely among women of Kinh ethnicity (aOR = 2.56; 95% CI, 1.45–4.50), urban residents (aOR = 1.27; 95% CI, 1.01–1.60), and those who were currently married or separated/divorced/widowed. Disparities by ethnicity, wealth, and geography widened over time. Conclusion Cervical cancer screening prevalence in Vietnam remains low and has declined in recent years. Significant disparities persist and have widened, particularly among ethnic minorities, rural populations, and women with lower socioeconomic status. To meet national and global cervical cancer elimination goals, urgent policy action is needed to expand equitable access to screening and reduce structural barriers for underserved populations.