Background: Cervical cancer is the commonest cancer of women’s reproductive system, and is caused by a progression of precancerous lesions of the cervix. Studies on the prevalence and associated factors of precancerous lesions of the cervix are very limited in Ethiopia, particularly in the study area.

Objective: This study aimed to assess precancerous lesions of the cervix and associated factors among women of East Gojjam, northwest Ethiopia in 2020.

Methods: A facility-based cross-sectional study was conducted on 340 cervical cancer screened women in three hospitals of East Gojjam from February to April 2020. Data were collected by six BSc-qualified nurses who were working in the selected hospitals. EpiData Manager and SPSS 26 were used for data management and analysis. After the data had been clean, descriptive analysis was done and multivariate logistic regression used to identify predictors of precancerous lesions of the cervix. Statistical significance was taken to be P<0.05.

Results: Of the 340 recruited women, 15.3% (95% CI 11.83%–19.54%) had precancerouscervical lesions. Mean age was 37.11±9.3 years. Age 46–55 (AOR 3.8, 95% CI 1.21–12.47)years, age 56–65 (AOR 12.26, 95% CI 3.18–47.18) years, residing rurally (AOR 2.04, 95% CI1.12–3.7), prolonged use of oral contraceptive pills (AOR 9.11, 95% CI 1.14–72.8), history of sexual transmitted infection (STI; AOR 3.40, 95% CI 1.32–8.78), HIV-positive status (AOR4.89, 95% CI 1.54–15.49), and number of lifetime sexual partners (AOR 9.87, 95% CI 1.38–70.4) were important factors associated with precancerous lesions of the cervix.

Conclusion: We found relatively high prevalence of precancerous cervical lesions. Age, rural residence, prolonged use of oral contraceptives, STI, multiple sexual partners, and being HIV-positive were important factors associated with precancerous cervical lesions.Women aged >46 years, with a history of STI, being HIV infected, and with a history of multiple sexual partners should be encouraged to get screened for cervical cancer.

Keywords: Visual inspection after acetic acid, Precancerous lesions of cervix, Cervical cancer, East Gojam Zone