Cervical Cancer Screening in Nigeria: A Social Media Survey of Women's Awareness, Beliefs, and Screening Uptake
Abstract
Background: Cervical cancer (CC) remains a leading cause of preventable mortality among women in Nigeria and other low- and middle-income countries (LMICs), mainly due to inadequate screening uptake despite increasing public health campaigns. This study assessed awareness, attitudes, and screening behaviours related to cervical cancer among women residing in Nigeria.
Methods: This was a cross-sectional online survey conducted using a structured, self-administered questionnaire that was distributed via social media platforms. A total of 718 valid responses from women aged 18 years and above were analysed. Descriptive statistics were used to summarise the sociodemographic variables, awareness levels, and screening behaviours of the respondents. The associations between cervical cancer screening uptake and relevant variables were tested using Pearson’s chi-square.
Results: Most respondents (92.9%) were aware of CC screening, yet only 29.9% had ever undergone a Pap smear or Human Papillomavirus (HPV) test. Only 32.2% had acted on that knowledge among those who were aware. Furthermore, 44.9% indicated they knew when screening should be done, but only 57.1% correctly identified the recommended three-year interval. Screening uptake was significantly associated with awareness (p = 1.27 × 10⁻⁶), marital status (p = 0.00072), age group (p = 2.09 × 10⁻⁹), and HPV vaccination status (p = 0.00020). The most frequently cited barriers to screening were cost (43.3%), limited access to screening centres (27.3%), and lack of awareness (23.6%). While 96.7% agreed that early detection improves survival, the media were widely acknowledged as an influential source of health information.
Conclusion: High awareness and education levels among Nigerian women did not translate into adequate CC screening uptake. Addressing systemic barriers such as cost, misinformation, and limited-service access is essential. Targeted interventions that combine accurate health education, subsidised screening, and culturally sensitive outreach, particularly for younger, unmarried, and unvaccinated women, are crucial to improving uptake and reducing the cervical cancer burden in Nigerian women.
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