Abstract

The breast cancer cases are increasing, and it is the third leading cause of morbidity and mortality among cancer cases in women in Cambodia. This study explores how access to digital tools, media exposure, transportation, travel time to health facilities, and autonomy in health decisions relate to breast cancer screening among Cambodian women aged 15 to 49. After excluding 204 women who were unaware of breast or cervical cancer screening, the final weighted sample comprised 19,292 participants. The outcome was whether a woman had ever received a breast examination from a healthcare provider. We used multivariable logistic regression to assess associations between screening and key factors, adjusting for demographic and socioeconomic characteristics. Only 10.9% (95% CI: 9.7%–11.6%) of women had undergone a breast exam. Exposure to multiple forms of media was associated with a higher odd of screening (AOR = 1.47; 95% CI: 1.13–1.91). Phone ownership—whether a basic mobile phone (AOR = 1.35; 95% CI: 1.03–1.78) or smartphone (AOR = 1.37; 95% CI: 1.03–1.82)—was also positively associated. In contrast, longer travel times of over 30 minutes (AOR = 0.55; 95% CI: 0.39–0.78) and a lack of autonomy in healthcare decisions (AOR = 0.70; 95% CI: 0.52–0.94) were associated with reduced screening. Wealthier women had greater odds of being screened (AOR = 1.86; 95% CI: 1.40–2.48). The findings underscore the need to strengthen communication, improve access to care, and support women’s decision-making to increase screening rates in Cambodia.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The author(s) received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The original CDHS protocol was approved by the National Ethical Committee for Health Research, Ministry of Health of Cambodia issue date 10 May 2021 (Ref #: 083 NECHR), and the Institutional Review Board (IRB) of ICF in Rockville, Maryland, USA.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

This study used the 2021-2022 Cambodia Demographic and Health Survey (CDHS) datasets. The DHS data are publicly available from the website at (URL:https://www.dhsprogram.com/data/available-datasets.cfm).

AbbreviationsACSAmerican Cancer SocietyAORAdjusted odds ratioBMIBody mass indexCDHSCambodia Demographic Health SurveyEAEnumeration areasHPVHuman papillomavirusNCDsNoncommunicable diseasesPPSProbability proportional to sizeVIAVisual inspection with acetic acidWRAWomen at reproductive ageWHOWorld Health Organization.