Abstract

Cervical cancer remains an important public health concern among women and continues to contribute substantially to cancer-related morbidity and mortality, particularly in settings where access to preventive services and early detection is limited. Cervical cancer is largely preventable through vaccination against human papillomavirus (HPV), appropriate screening, early identification of precancerous lesions, and timely treatment. Cervical cancer screening practices refer to women's utilization of recommended screening services, awareness of appropriate screening methods, regularity of screening where indicated, and willingness to seek professional evaluation when necessary. Cervical cancer awareness involves knowledge of the causes and risk factors of cervical cancer, the role of HPV infection, warning signs, prevention, available screening methods, and the importance of early detection. In Nigeria, inadequate awareness, misconceptions about cervical cancer and screening, fear of pain or diagnosis, stigma, concerns about confidentiality, cost of services, limited availability of screening facilities, and poor access to healthcare information may discourage women from utilizing screening services. Improving cervical cancer awareness may increase women's understanding of their susceptibility to the disease, the benefits of screening, and the importance of early detection, thereby encouraging appropriate screening practices. Against this background, this study investigates the effect of cervical cancer awareness on cervical cancer screening practices among women of reproductive age in Nigeria. The study is anchored on the Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding women's decisions to participate in cervical cancer screening. The Theory of Planned Behavior proposes that attitudes, subjective norms, and perceived behavioural control influence behavioural intentions and subsequent health practices, including screening utilization. The Knowledge-Attitude-Practice framework provides a basis for examining how increased awareness and favourable attitudes toward cervical cancer prevention may influence screening practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how cervical cancer awareness may influence cervical cancer screening practices among women of reproductive age in Nigeria. The study adopts a quantitative cross-sectional research design. Primary data will be collected from women of reproductive age in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible participants. Cervical cancer awareness will be measured using knowledge of HPV infection, cervical cancer risk factors, signs and symptoms, prevention, available screening methods, screening intervals where applicable, and the benefits of early detection. Cervical cancer screening practices will be assessed based on participants' history of screening, type of screening method used, timing of the most recent screening, frequency of screening where applicable, utilization of screening services, and willingness to undergo recommended screening. Where available, screening records may be reviewed to validate self-reported information. Descriptive statistics will be used to summarize participants' sociodemographic and reproductive characteristics, levels of cervical cancer awareness, and screening practices. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple logistic regression analysis, will be employed to determine the effect of cervical cancer awareness on screening practices. Appropriate diagnostic tests will also be conducted to assess multicollinearity, model specification, goodness of fit, and the robustness of the findings. The study anticipates that higher levels of cervical cancer awareness will have a significant positive effect on cervical cancer screening practices among women of reproductive age in Nigeria. Women with greater awareness are expected to demonstrate better knowledge of HPV, cervical cancer risk factors, prevention, available screening options, and the importance of early detection. Increased awareness may reduce misconceptions and fear, improve perceived susceptibility and perceived benefits of screening, and encourage women to utilize appropriate cervical cancer screening services. However, awareness alone may not guarantee screening uptake because women may continue to face barriers such as cost, distance to healthcare facilities, limited availability of screening services, fear of examination or diagnosis, stigma, concerns about privacy, and inadequate access to trained healthcare professionals. Consequently, cervical cancer awareness programmes are expected to be most effective when combined with accessible, affordable, confidential, culturally appropriate, and quality-assured screening services. This study is expected to contribute to the literature on cervical cancer prevention, women's health, cancer screening, health education, and public health in Nigeria by providing empirical evidence on the relationship between cervical cancer awareness and cervical cancer screening practices among women of reproductive age. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, primary healthcare facilities, hospitals, cancer control programmes, reproductive health organizations, community health workers, development partners, and policymakers regarding strategies for improving cervical cancer prevention and screening. The study will also provide evidence-based recommendations for strengthening cervical cancer education, increasing awareness of HPV and cervical cancer prevention, addressing misconceptions and stigma, expanding community-based screening programmes, improving access to appropriate screening services, strengthening referral and follow-up systems, and integrating cervical cancer prevention into routine women's reproductive health services across Nigeria.

Keywords: Cervical cancer awareness, cervical cancer screening, screening practices, women of reproductive age, human papillomavirus, HPV, cancer prevention, health education, women's health, early detection, public health, Nigeria.