Abstract
Background: Cervical cancer is a major public health issue in Uganda, causing over 2,500 deaths annually. Despite the high burden, most Ugandan women lack access to preventive services such as vaccination and screening due to geographic, financial, and health system barriers. Studies have documented geographic disparities in cervical cancer outcomes; however, spatial techniques have been underutilized to guide resource allocation. This research aimed to develop a geospatial model to identify priority areas for intervention.
Aim: To enhance cervical cancer surveillance through geospatial modeling by quantifying geographic distributions, spatial relationships, and accessibility gaps in southwestern Uganda.
Methods: Cervical cancer registry data from the MRRH were integrated with granular spatial information on health facilities, roads, sociodemographic, sexual behaviors, and HIV prevalence to enable multifaceted investigations of risk factors shaping observed geographic cancer patterns. Hotspot analysis, spatial regression, buffer analysis, and weighted risk overlay modeling were implemented to guide the modeling.
Results: Significant hotspots of high cervical cancer incidence were identified in Buhweju (Gi* z score: 4.21, p<0.001) and Ibanda (Gi* z score: 3.87, p=0.002), where rates spiked over 100 per 100,000 women. Rural populations also had 2.15-fold greater odds of having late-stage disease. Women residing more than 5 km from the nearest screening site faced 38% lower odds of utilizing services compared to those residing within 5 km, highlighting severe distance decay effects on prevention.
Conclusions: Significant geographic disparities exist in cervical cancer burden and prevention access in southwestern Uganda. Spatial modeling provided actionable evidence for decentralizing services to address barriers.