Abstract
<title>Abstract</title> <p> <bold>Background:</bold> Although cervical cancer is increasing globally, many women with precancerous lesions do not adhere to recommended treatment and follow up visits. We assessed loss to follow up (LTFU) and associated factors among women previously screened for cervical cancer in Kakumiro district, western Uganda. <bold>Methods:</bold> This cross-sectional study involved 167 women who were initiated on treatment for precancerous lesions at three health facilities between January 2021 and December 2023. Data collection included face to face interviews using a semi-structured questionnaire, focusing on social-demographic and health system factors influencing follow up. LTFU was defined as women who did not return for follow-up treatment within ninety days of treatment initiation. A modified Poisson regression model identified factors associated with LTFU, with significance set at p-value <0.05. Quantitative data were analyzed using STATA 14.0. <bold>Results:</bold> Of the participants, 61% (102/167) were LTFU. The majority were aged 25-34 years 55.1% (n=92) and married 55.7% (n=93). Factors significantly associated with LTFU included being married (adj. PR =1.76,95% CI: 1.13, 2.73), age 25-34 years (adj.PR=1.77, 95% CI: 1.25, 2.49), living more than 15 km from the health facility (adj.PR=1.86, 95% CI: 1.06, 3.26), long waiting time (4+ hours: adj.PR=1.33, 95% CI: 1.05, 1.68 ), and inadequate health facility staffing (adj.PR=1.74, 95% CI: 1.31, 2.32). <bold>Conclusion:</bold> Six in ten women initially treated for cervical precancerous lesions in Kakumiro district did not return for follow-up. Strategies targeting married women, women aged 25-34 years, and those living far from health facilities along with efforts to reduce waiting times may improve follow up adherence and treatment completion. </p>