Working Status and Cervical Cancer Screening Experience among Urban Women in Indonesia: Evidence from the 2023 Indonesia Health Survey

https://doi.org/10.53770/medica.v8i9.1250

Authors

  • Fitri Indrawati Faculty of Medicine, Universitas Negeri Semarang, Semarang, Central Java, Indonesia
  • Maria Ulfa Nur Hidayanti Faculty of Medicine, Universitas Negeri Semarang, Semarang, Central Java, Indonesia

Keywords

Cervical Cancer Screening Working Status Urban Women Wealth Quintile Indonesia

Abstract

Cervical cancer remains the second most common cancer among women in Indonesia, while lifetime cervical cancer screening remains low. This study examined the association of current working status, age, education, and household wealth with self-reported lifetime cervical cancer screening experience among urban women in Indonesia. This cross-sectional study used secondary data from the 2023 Indonesia Health Survey (Survei Kesehatan Indonesia/SKI), including urban women aged ≥15 years eligible for the cervical cancer screening item (G43.G) (n=156,722; n=156,716 in the multivariable model due to missing wealth-quintile data). Analyses accounted for the multistage stratified cluster sampling design, including primary sampling units, strata, and sampling weights. Design-based chi-square tests and weighted multivariable logistic regression were performed. Overall, 8.97% (95% CI: 8.71–9.25%) of urban women reported ever undergoing cervical cancer screening by Pap smear or visual inspection with acetic acid (IVA). After adjustment, non-working women had lower odds of ever being screened than working women (aOR=0.91; 95% CI: 0.86–0.97; p=0.002). Screening odds were higher among women aged up to 45–54 years, those with higher education (aOR=3.42 for university graduates versus no formal education), and those in higher wealth quintiles (aOR=2.05 for the wealthiest versus poorest quintile). Working status, education, and household wealth were significantly associated with cervical cancer screening experience among urban Indonesian women. Equity-focused strategies should prioritize non-working, less-educated, and economically disadvantaged women to improve screening coverage and support cervical cancer elimination efforts.

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References

Akokuwebe, M. E., Idemudia, E. S., Lekulo, A. M., & Motlogeloa, O. W. (2021). Determinants and levels of cervical cancer screening uptake among women of reproductive age in South Africa: Evidence from South Africa Demographic and Health Survey data, 2016. BMC Public Health, 21, Article 1965. https://doi.org/10.1186/s12889-021-12020-z

Anwar, S. L., Tampubolon, G., Van Hemelrijck, M., Hutajulu, S. H., Watkins, J., & Wulaningsih, W. (2018). Determinants of cancer screening awareness and participation among Indonesian women. BMC Cancer, 18, 208. https://doi.org/10.1186/s12885-018-4125-z

Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia. (2019). Laporan Nasional Riset Kesehatan Dasar (Riskesdas) 2018. Jakarta: Kementerian Kesehatan Republik Indonesia.

Badan Kebijakan Pembangunan Kesehatan, Kementerian Kesehatan Republik Indonesia. (2023). Survei Kesehatan Indonesia (SKI) 2023 [Dataset]. Jakarta: Kementerian Kesehatan Republik Indonesia.

Denny, L., de Sanjose, S., Mutebi, M., Anderson, B. O., Kim, J., Jeronimo, J., ... & Sankaranarayanan, R. (2017). Interventions to close the divide for women with breast and cervical cancer between low-income and middle-income countries and high-income countries. The Lancet, 389(10071), 861-870. https://doi.org/10.1016/S0140-6736(16)31795-0

Ekawati, F. M., Listiani, P., Idaiani, S., At Thobari, J., & Hafidz, F. (2024). Cervical cancer screening program in Indonesia: Is it time for HPV-DNA tests? Results of a qualitative study exploring the stakeholders’ perspectives. BMC Women’s Health, 24, 125. https://doi.org/10.1186/s12905-024-02946-y

Gopalkrishnan, K., & Karim, R. (2025). Addressing global disparities in cervical cancer burden: a narrative review of emerging strategies. Current HIV/AIDS Reports, 22(1), 18. https://doi.org/10.1007/s11904-025-00727-2

Hull, R., Mbele, M., Makhafola, T., Hicks, C., Wang, S. M., Reis, R. M., ... & Dlamini, Z. (2020). Cervical cancer in low and middle-income countries. Oncology Letters, 20(3), 2058-2074. https://doi.org/10.3892/ol.2020.11754

International Agency for Research on Cancer. (2024). Globocan 2022: Indonesia fact sheet. Global Cancer Observatory, World Health Organization. https://gco.iarc.who.int/media/globocan/factsheets/populations/360-indonesia-fact-sheet.pdf

Jouya, S., Shahabinia, Z., Mazidimoradi, A., Allahqoli, L., Salehiniya, H., & Lee, D. Y. (2026). Cervical cancer epidemiology: Global incidence, mortality, survival, risk factors, and equity in HPV screening and vaccination. Journal of Clinical Medicine, 15(3), 1079. https://doi.org/10.3390/jcm15031079

Kementerian Kesehatan Republik Indonesia. (2016). Panduan penatalaksanaan kanker serviks [Guideline for cervical cancer management]. Jakarta: Kementerian Kesehatan Republik Indonesia.

Kementerian Kesehatan Republik Indonesia. (2023). Peraturan Menteri Kesehatan Republik Indonesia Nomor 3 Tahun 2023 tentang Standar Tarif Pelayanan Kesehatan dalam Penyelenggaraan Program Jaminan Kesehatan. (2023). Jakarta: Kementerian Kesehatan Republik Indonesia.

Mulyanto, J., Kringos, D. S., & Kunst, A. E. (2019). Socioeconomic inequalities in healthcare utilisation in Indonesia: A comprehensive survey-based overview. BMJ Open, 9(7), Article e026164. https://doi.org/10.1136/bmjopen-2018-026164

Petersen, Z., Jaca, A., Ginindza, T. G., Maseko, G., Takatshana, S., Ndlovu, P., ... & Moyo, S. (2022). Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Women's Health, 22(1), 486. https://doi.org/10.1186/s12905-022-02043-y

Rana, T., Chan, D. N. S., Law, B. M. H., Choi, K. C., Shrestha, S., & So, W. K. W. (2025). Determinants of cervical cancer screening utilisation among women in the least developed countries: A systematic review and meta-analysis. PLOS ONE, 20(6), Article e0321627. https://doi.org/10.1371/journal.pone.0321627

Robbers, G. M. L., Bennett, L. R., Spagnoletti, B. R. M., & Wilopo, S. A. (2021). Facilitators and barriers for the delivery and uptake of cervical cancer screening in Indonesia: A scoping review. Global Health Action, 14(1), 1979280. https://doi.org/10.1080/16549716.2021.1979280

Samaria, D. (2024). Perceived benefits and barriers related to cervical cancer screening among married women in Indonesia. NERS Jurnal Keperawatan, 22(1), 11-18. https://ners.fkep.unand.ac.id/index.php/NJK/article/view/358

Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2021: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660

World Health Organization. (2020). Global strategy to accelerate the elimination of cervical cancer as a public health problem. https://www.who.int/publications/i/item/9789240014107

World Health Organization. (2024). WHO, UNFPA commend Indonesia’s efforts to eliminate cervical cancer, urge streamlined vaccine strategy and enhanced screening [News release]. https://www.who.int/indonesia/news/detail/15-11-2024-who--unfpa-commend-indonesia-s-efforts-to-eliminate-cervical-cancer--urge-streamlined-vaccine-strategy-and-enhanced-screening

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Published

2026-09-30

How to Cite

Indrawati, F., & Hidayanti, M. U. N. (2026). Working Status and Cervical Cancer Screening Experience among Urban Women in Indonesia: Evidence from the 2023 Indonesia Health Survey. MEDICA (International Medical Scientific Journal), 8(9), 954–966. https://doi.org/10.53770/medica.v8i9.1250