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Effect of Cervical Cancer Awareness on Cervical Cancer Screening Uptake among Women of Reproductive Age in Nigeria

Abstract

Cervical cancer remains an important public health concern among women, particularly in settings where access to preventive healthcare, screening, early detection, and treatment services is limited. Cervical cancer screening is an important preventive health intervention because it can facilitate the detection of precancerous changes and early disease, thereby creating opportunities for timely management and reducing the risk of advanced cervical cancer. Cervical cancer awareness provides women with information about the disease, risk factors, symptoms, prevention, screening methods, eligibility, recommended screening intervals, available screening services, and the importance of early detection and treatment. Cervical cancer screening uptake refers to the utilization of recommended cervical cancer screening services by eligible women through appropriate healthcare facilities and screening programmes. In Nigeria, low screening uptake may be associated with inadequate awareness, misconceptions about cervical cancer and screening, fear of pain or positive results, stigma, financial constraints, limited access to screening facilities, geographical barriers, lack of recommendation by healthcare providers, and inadequate knowledge of screening eligibility and procedures. Effective cervical cancer awareness may improve women's knowledge, risk perception, confidence, and willingness to utilize available screening services. Against this background, this study investigates the effect of cervical cancer awareness on cervical cancer screening uptake among women of reproductive age in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding women's screening decisions through perceived susceptibility to cervical cancer, perceived severity, perceived benefits of screening, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, and environmental conditions in shaping preventive health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how cervical cancer awareness may improve women's knowledge and attitudes and influence screening uptake. Collectively, these theoretical perspectives provide a suitable framework for explaining how cervical cancer awareness may influence cervical cancer screening uptake among women of reproductive age in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from women of reproductive age attending selected public and private healthcare facilities, reproductive health clinics, community health programmes, and other appropriate healthcare settings in Nigeria using a structured interviewer-administered questionnaire, cervical cancer knowledge and awareness assessment, and screening uptake assessment tool. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible women. Where feasible, selected communities, healthcare facilities, or participant groups will be assigned to intervention and comparison groups. Women in the intervention group will receive structured cervical cancer awareness education covering cervical cancer risk factors, prevention, signs and symptoms, screening methods, eligibility, recommended screening intervals, screening procedures, benefits of early detection, available screening services, and the importance of seeking appropriate healthcare. Cervical cancer screening uptake will be assessed using indicators such as previous screening history, recent utilization of recommended screening services, intention to undergo screening, and completion of screening following the educational intervention. Where feasible, reported screening uptake will be verified through healthcare records or screening documentation. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, reproductive health history, previous cervical cancer information, awareness levels, and screening history. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic regression analysis, will be used to determine the effect of cervical cancer awareness on screening uptake. Where appropriate, screening uptake before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that cervical cancer awareness has a significant positive effect on cervical cancer screening uptake among women of reproductive age in Nigeria. Women exposed to structured cervical cancer awareness education are expected to demonstrate improved knowledge of cervical cancer risk factors, prevention, screening methods, and the importance of early detection. Awareness may increase women's perception of their susceptibility to cervical cancer and the benefits of screening while reducing misconceptions, fear, stigma, and uncertainty regarding screening procedures. Education may also encourage women to discuss screening with healthcare professionals and utilize available screening services. However, awareness alone may not guarantee screening uptake because women may continue to experience barriers such as cost, limited availability of screening services, geographical inaccessibility, fear of screening procedures, concerns about privacy, inadequate healthcare-provider recommendation, and limited availability of trained screening personnel. Consequently, cervical cancer awareness is expected to be most effective when supported by affordable and accessible screening services, trained healthcare professionals, appropriate referral systems, community mobilization, and supportive reproductive-health policies. The study is expected to contribute to the literature on cervical cancer prevention, cancer awareness, cervical cancer screening, reproductive health, women's health, health education, preventive healthcare, and public health in Nigeria by providing empirical evidence on the effect of cervical cancer awareness on screening uptake among women of reproductive age. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, primary healthcare centres, reproductive health programmes, cancer-control programmes, nurses, midwives, physicians, community health workers, development partners, and policymakers regarding strategies for improving cervical cancer prevention and early detection. The study will also provide evidence-based recommendations for strengthening cervical cancer awareness programmes, integrating screening education into reproductive and primary healthcare services, improving access to affordable screening, strengthening community-based cancer education, addressing misconceptions and stigma, increasing healthcare-provider recommendations for screening, and promoting timely utilization of cervical cancer screening services among women of reproductive age in Nigeria.

Keywords: Cervical cancer awareness, cervical cancer screening uptake, women of reproductive age, Nigeria, cervical cancer prevention, cancer screening, reproductive health, women's health, health education, early detection, preventive healthcare, cancer awareness, community health, public health.