Background: Globally, cervical cancer was the fourth most frequent cancer among women. An estimated 570,000 cases of cervical cancer representing 6.6% of all female cancers were reported in the year 2018. Approximately, 90% of deaths from cervical cancer occurred in low- and middle-income countries. Diagnosing cervical cancer at an early stage and providing access to effective treatment can significantly improve the likelihood of survival. However, the accessibility of the screening service, as well as the coverage of the Human Papillomavirus vaccine in most parts of the world, is not optimal.

Objective: This study aimed to assess the determinants of cervical precancerous lesions among women screened in selected hospitals of Oromia region, Ethiopia.

Methods: A hospital-based un-matched case-control study was conducted in three hospitals providing regular screening services for cervical precancerous lesions in Oromia region, Ethiopia. An interviewer-administered questionnaire was used to collect data. Data were entered into EpiData version 3.1 and analyzed using Statistical Package for Social Science (SPSS) version 20. Odds ratios with 95% confidence intervals were calculated to identify the presence and strength of association. Statistical significance was declared at P-value < 0.05.

Results: A total of 74 cases and 148 controls were included in this study.  The mean age of cases and controls was 40.5 ± 13.3 years and 37.1 ± 11.9 years, respectively. Women with parity of four or more children had two times higher odds of having cervical precancerous lesions compared to their counterparts (AOR: 2.1, 95% CI: 1.3-4.0). Women with a history of post-coital bleeding were associated with three times higher odds of having cervical precancerous lesions (AOR: 3.3, 95% CI: 1.2-8.0). History of smoking (AOR: 8.9, 95% CI: 1.6-48.0), history of sexually transmitted infection (AOR: 1.9, 95% CI: 1.1-3.5), and having multiple sexual partners (AOR: 3.2, 95% CI: 1.2-8.0) were also found to be determinants of the cervical precancerous lesion.

Conclusion: This study found that parity greater than four children, post-coital bleeding, history of sexually transmitted infections, having multiple sexual partners, and history of smoking were significantly associated with the cervical precancerous lesion. Women with the mentioned characteristics should be encouraged to have close follow up for the screening. Additionally, awareness creation activities on the identified risk factors are strongly recommended for all women.

Key terms: Cervical precancerous lesions, Cervical cancer, Determinants, Oromia region, Ethiopia