Abstract
Cervical cancer (CC) is an extremely preventable and curable disease with early detection and treatment. Unfortunately, the practice of cervical cancer prevention (CCP) remains poor in resource constrained countries. This study aimed to identify determinants of knowledge of CC, attitude towards cervical cancer screening (CCS) and practice of CCP among antenatal attendees in a tertiary hospital in Southwest Nigeria as they are sexually active women. This was a cross-sectional survey of a cohort of 287 antenatal attendees using a self-administered structured questionnaire to assess their knowledge of CC, attitude towards screening and uptake of screening and human papillomaviruses (HPVs) vaccination as methods of practice of CCP. Data was analysed using the Statistical Package for Social Sciences version 20.0. Descriptive statistics were conducted for all relevant data. Categorical variables were explored using chi-square test and the independent variables with significant associations (p-value < 0.05) entered into logistic regression analysis. The mean age was 30.62 ± 4.5 years. Three-fifths (60.6%) of the women had good knowledge of CC while 47.4% had heard about CCS. Majority (75.6%) were willing to undergo CCS thereby exhibiting positive attitude towards screening. The practice of CCP was poor as only 27 (9.4%) had ever been screened for CC while 10 (3.5%) had received the HPV vaccine. Interestingly, none of the women who had received the HPV vaccine had been screened for CC. Those with tertiary education were more likely (OR = 2.140, 95% CI = 1.166–4.979) to exhibit positive attitude to CCS, while those with poor knowledge were about two times less likely to have a positive attitude (OR = 0.532, 95% CI = 0.291–0.972). Poor knowledge of CC was associated with lesser odds (OR = 0.061, 95% CI = 0.008–0.471) of practice of CCP. In Nigeria, the burden of CC can be reduced if women are educated and health care providers challenged to recommend CCS and HPV vaccination.
Highlights
Cervical cancer (CC) is the most common gynaecological cancer
Ninety-nine percent of all cases are linked to infection with high-risk human papillomaviruses (HPVs) which may be transmitted through sexual contact [1]
This makes it a major public health problem with a predisposition for middle-aged women in resource constrained countries [2]. Most of these deaths are largely preventable with access to comprehensive cervical cancer prevention (CCP) and control programmes which improve uptake of HPV vaccination among young girls, screening all at-risk women and treating pre-cancerous lesions [3]
Summary
Cervical cancer (CC) is the most common gynaecological cancer. Ninety-nine percent of all cases are linked to infection with high-risk human papillomaviruses (HPVs) which may be transmitted through sexual contact [1]. Of the 570,000 cases of CC diagnosed globally in 2018, there were 311,000 deaths (85% of which were from developing countries). This makes it a major public health problem with a predisposition for middle-aged women in resource constrained countries [2]. Most of these deaths are largely preventable with access to comprehensive cervical cancer prevention (CCP) and control programmes which improve uptake of HPV vaccination among young girls, screening all at-risk women and treating pre-cancerous lesions [3]
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