Cancer Screening In Nigeria Research Articles

A systematic review of healthcare professionals and women's experiences and perceptions of colposcopy method of cervical cancer screening in Nigeria

Background: Cervical cancer continues to pose a significant public health issue in Nigeria, characterized by high rates of incidence and mortality. Colposcopy is integral to the cervical cancer screening process and its early detection. However, the uptake of colposcopy screening in Nigeria remains suboptimal, with various factors contributing to this phenomenon. Comprehending the experiences and perceptions of healthcare professionals and patients concerning colposcopy for cervical cancer screening is vital to enhance screening initiatives and alleviate the impact of cervical cancer in Nigeria. This systematic review aims to identify the gap in knowledge and synthesize the existing literature on the experiences and perceptions of healthcare professionals and patients regarding colposcopy for cervical cancer screening in Nigeria. Methods: A comprehensive search of the literature was conducted in Academic search elite, African journals online (AJOL), CINAHL, MBASE, psycho info, Cochrane, Medline (via PubMed) and Scopus databases from 2010 until March 2023. The quality of the included studies was assessed using Joanna Briggs Institute (JBI) critical appraisal tool. Thematic analysis was deployed to synthesize the extracted data. Results: Fourteen (14) studies satisfied the inclusion criteria. Most studies were conducted in developed countries and urban settings. The review revealed key themes that were categorized into four: insufficient knowledge/awareness, emotional factors, cultural/religious factors, and organizational/systemic factors. Conclusion: The review identified barriers to colposcopy screening in Nigeria, highlighting the need for targeted interventions to improve cervical cancer screening rates. Hence, the need for a qualitative study in rural parts of Nigeria to explore the in-depth understanding of patients' and healthcare professionals’ regarding colposcopy screening utilization.

Abstract PO4-20-01: A PROSPECTIVE PILOT STUDY OF MAMMOGRAPHIC PREDICTION OF WOMEN’S RISK (M-POWER) IN NIGERIA

Abstract Background There have been no sustained efforts at stemming the rising incidence and mortality from breast cancer in sub-Saharan African countries like Nigeria. Mammography is the gold standard for breast cancer screening and is associated with improved survival particularly among women 50 to 69. Reports from various parts of Nigeria show very low mammography screening uptake. Causes include lack of geographical access, financial issues (less than 5% of the population is covered by the National Health Insurance Scheme), lack of awareness and the increasing expertise gap from the continued brain drain, despite the already low number of radiologists in the country. Given these obstacles, our long-term goal is to devise a rational basis for identifying mammographic risk categories so that this resource can be deployed cost-effectively. We propose to carry out a 5-year prospective mammographic study in Nigerian women and to use machine learning to develop a risk prediction algorithm, so that following a single screening mammogram, the appropriate frequency of subsequent mammograms can be determined. Our immediate goal is to examine the feasibility of performing such a study. To this end, we have initiated a cross-sectional pilot study that will recruit up to 2000 women in multiple urban centers in Nigeria. Objective: To explore feasibility of creating a digital mammography image database representative of the radiological features of the breast of Nigerian women. Objective: To explore feasibility of creating a database that can be used to inform a predictive mammographic risk model for breast cancer and identify the appropriate population that will benefit from breast cancer screening in Nigeria. Design This is a prospective, open-label, cross-sectional pilot study in 2000 eligible women in Nigeria and will include a single screening mammography examination. The mammography images will be read by the study radiologist. The Pilot phase will determine the feasibility and aid in the design of the of the Extension phase in which up to 20,000 participants will undergo yearly mammography examination for 5 years. Incident cases of breast cancer during the study period will permit the development of deep learning algorithms for predicting the risk of breast cancer in this population. Main Eligibility Criteria: Inclusion Criteria All consecutive women aged ≥40 years and < 65 years presenting for screening mammography at the participating institutions will be eligible. Signed study-specific written informed consent. Exclusion Criteria Complaint of a focal dominant lump or a bloody or clear nipple discharge. History of breast implants. Any woman who is pregnant or has reason to believe that she might be pregnant. Statistical Methods Analyses of continuous data will be summarized using descriptive statistics where the following parameters will be reported: Number of observations, Number of missing observations, Mean, Median, Standard deviation (SD), Minimum (Min), Maximum (Max) Categorical data will be presented with absolute and relative frequency (n and %). Present Accrual and Target accrual Two hundred ninety-six women have been enrolled and screening digital mammographic images using GE Digital mammography equipment have been obtained on all participants at 2 study sites in 2 cities in Southern Nigeria. The target accrual is 2000 participants over 12 months. Conclusion Our preliminary experience to date suggests the feasibility of proceeding with a larger prospective study to define mammographic risk groups in Nigerian women which will permit the rational allocation of resources for breast cancer prevention activities in this underserved population. Contact Information: Dr Toyin Shonukan at tshonukan@yemanjacancercare.org Citation Format: Oluwatoyin Shonukan, Hyelakumi Ibrahim, Esther Udoh, Wahab Egbeolu, Kanyinsola Oyeyinka, Jonas Haggstrom. A PROSPECTIVE PILOT STUDY OF MAMMOGRAPHIC PREDICTION OF WOMEN’S RISK (M-POWER) IN NIGERIA [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-20-01.

Examining the Challenges and Strategies for Improving Cervical Cancer Screening in Nigeria

Background: Cervical cancer is one of the most treatable cancers when detected early and managed. Unfortunately, the mortality rate is projected to surge in Nigeria.Objective: This review aims to provide updated information on challenges and strategies for improving cervical cancer screening in Nigeria.Methods: In this review, scientific papers published in electronic databases including PubMed, Scopus, and Google Scholar were retrieved using search themes such as “cervical cancer”, “risk factors”, and “preventive methods” were examined.Results: The true prevalence of cervical cancer is underestimate in Nigeria because most cases of cervical cancer are not documented. Lack of awareness, cultural barriers, poor infrastructure, unfavorable perception, shortage of supplies, lack of partner involvement, provider-related factors, poor monitoring, and evaluation system were the major barriers that hinder cervical cancer screening service in Nigeria.Conclusion: Lack of awareness, unfavorable perception, problems with health system structure and process, and cultural conditions were major barriers in Nigeria. Hence, packages of intervention is necessary create awareness, provide essential equipment, increase access to health facilities, and strengthening follow up system is indispensable for service improvement by the government and non-governmental organizations, world health organization inclusive.International Journal of Human and Health Sciences Vol. 08 No. 01 Jan’24 Page: 22-31

Utilization of opportunistic cervical cancer screening in Nigeria.

While various interventions have been conducted to decrease cervical cancer's burden in Nigeria, no study has examined the trends in cervical cancer screening uptake over time. The present study sought to fill this gap in knowledge using data collected at Jos University Teaching Hospital (JUTH) in Nigeria. Data collected continuously between 2006 and 2016 were analyzed to identify trends in screening uptake, changes in risk factors for cervical cancer, and to identify factors for women screened at Jos University Teaching Hospital (JUTH) in Jos, Nigeria. Categorical analyses and logistic regression models were used to describe patient characteristics by year, and to identify factors associated with repeated screening uptake. A total of 14,088 women who were screened between 2006 and 2016 were included in the database; 2,800 women had more than one screening visit. Overall, screening uptake differed significantly by year. On average women were first screened at age 38. About 2% of women screened were women living with HIV. Most women (86%) had normal pap smear at first screening, with the greatest decreased risk of abnormalities observed between 2011 and 2014. Odds of a follow-up screening after a normal result decreased significantly between 2008 and 2016 compared to women screened in 2006 and 2007. Finally, women living with HIV had increased odds of follow-up screening after having a normal pap smear. These findings contribute to our understanding of the potential social and health system barriers to cervical cancer control in Nigeria. The findings may assist policy makers to design interventions to increase access and compliance to recommended screening schedules in this vulnerable population.

Evaluation of a Breast Cancer Screening Program in Nigeria using the Evaluability Assessment Model

There exists a paucity of policies and programs that support breast cancer screening in Nigeria. There is a clear need for effective programs that are cognizant of the local realities in Nigeria. The evaluability assessment model can be used as a cost effective and quick alternative to traditional evaluations to improve program practices and management and develop performance measures. This study uses an evaluability assessment to determine if a breast cancer screening program in Lagos, Nigeria was achieving its objectives and to adjust their activities to improve outcomes and processes to optimally serve its community. The evaluability assessment revealed the programs objectives are plausible given its resources and context. Program recommendations focused on improving staff management, developing benchmarks to measure outputs and outcomes, and examining more effective methods of disseminating program information to target population. This study is used as an example of how the six-step evaluability assessment model can be adapted to a multitude of programs to appraise program practices or performance measures.

Colorectal cancer screening in sub-Saharan Africa

Colorectal cancer screening in sub-Saharan Africa

Addressing missed opportunities for cervical cancer screening in Nigeria: a nursing workforce approach.

Cervical cancer is the commonest gynaecological cancer affecting women, especially in low and middle-income countries (LMICs). Despite the availability of evidence on multiple prevention pathways, including vaccination and screening, the cervical cancer burden continues to increase, especially in LMICs. This disease typifies health inequality as more than 85% of related morbidity and mortality occur among women of low socio-economic status residing in developing countries. In Nigeria, cervical cancer is the second leading cause of cancer morbidity and mortality. Sadly, Nigeria lacks a tailored cervical cancer control policy or population-based screening programme which is recommended. Consequently, existing screening services are opportunistic, sparsely distributed and have reached less than 9% of eligible Nigerian women. This article highlights the current status of cervical cancer screening in Nigeria, contextualises the role of female nurses and proffers novel approaches to address missed opportunities for screening by leveraging the nursing workforce.

Men's willingness to support HPV vaccination and cervical cancer screening in Nigeria.

Cervical cancer is the second most common female cancer in Nigeria, even though it can be prevented by vaccination and screening. The uptake of these preventive services is extremely low due to lack of spousal support and cost. Human papilloma virus (HPV) vaccines and cervical screening require finance as health services are mostly paid out of pocket. This study explored Nigerian men's willingness to encourage and pay for family member to obtain HPV vaccine and cervical screening. This is a cross-sectional study of 352 men aged 18-65 years living in 12 communities in the 6-geopolitical region. We found poor perception of HPV risk, and believed their family was not susceptible to cervical cancer. However, the majority (>80%) believed HPV vaccine and cervical screenings are important. Additionally, a good number (>58%) would encourage and pay for their family member to receive HPV vaccine and cervical screening. Residency, educational level and monthly income were significantly associated with willingness to encourage their family to receive HPV vaccine and cervical screening. Also, age group, marital status, residency, educational level and monthly income were significantly associated with the willingness to pay for HPV vaccine and cervical cancer screening. Majority were willing to encourage and pay for their family member to get vaccinated and receive cervical screening. This supports the findings that lack of male involvement may be an overlooked obstacle to cervical cancer prevention in developing countries.

Feasibility and performance of the fecal immunochemical test (FIT) for average-risk colorectal cancer screening in Nigeria.

There is a paucity of prospective data on the performance of the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening in sub-Saharan Africa. The aim of this exploratory analysis was to evaluate the feasibility and performance of FIT in Nigeria. This was a prospective, single-arm study. A convenience sample of asymptomatic, average-risk individuals between 40-75 years of age were enrolled at Obafemi Awolowo University Teaching Hospital. Study participants returned in 48 hours with a specimen for ova and parasite (O&P) and qualitative FIT (50ug/g) testing. Participants with a positive FIT had follow-up colonoscopy and those with intestinal parasites were provided treatment. Between May-June 2019, 379 individuals enrolled with a median age of 51 years (IQR 46-58). In total, 87.6% (n = 332) returned for FIT testing. FIT positivity was 20.5% (95% CI = 16.3%-25.2%). Sixty-one (89.7%) of participants with a positive FIT had a follow-up colonoscopy (n = 61), of whom 9.8% (95%CI:3.7-20.2%) had an adenoma and 4.9% (95%CI:1.0-13.7%) had advanced adenomas. Presence of intestinal parasites was inversely related to FIT positivity (6.5% with vs. 21.1% without parasites, p = 0.05). Eighty-two percent of participants found the FIT easy to use and 100% would recommend the test to eligible family or friends if available. Asymptomatic, FIT-based CRC screening was feasible and well tolerated in this exploratory analysis. However, the high FIT positivity and low positive predictive value for advanced neoplasia raises concerns about its practicality and cost effectiveness in a low-resource setting such as Nigeria.

Increasing Human Papillomavirus Vaccination and Cervical Cancer Screening in Nigeria: An Assessment of Community-Based Educational Interventions.

We explored the impact of two community-based educational interventions on Nigerian adults' knowledge and intention to take or encourage human papillomavirus (HPV) vaccine and cervical screenings. Face-to-face presentation and printed pamphlet intervention were delivered to 266 men and women aged 18 to 65 years in 12 locations in urban setting. At baseline, the majority (80%) had poor knowledge of HPV, and less than 12% had ever received or have a family member who had received HPV vaccine or cervical screening. Postintervention, there was significant increase (>70%) in the participants knowledge and intention to take or encourage HPV vaccination and cervical screening. In addition, more than half were willing to pay for HPV vaccine and screening even when expensive. Gender-focused and context-specific low-cost community-based educational interventions are effective in increasing HPV vaccine and cervical screening in sub-Saharan Africa.

An Exploratory Analysis of Fecal Immunochemical Test Performance for Colorectal Cancer Screening in Nigeria.

The fecal immunochemical test (FIT) for hemoglobin is recommended for colorectal cancer (CRC) screening in resource-limited environments. However, there are several unique variables that may alter FIT performance in this setting, including endemic intestinal parasites and high ambient temperature. This prospective study evaluated the performance of FIT in asymptomatic, average-risk individuals of screening age in rural Nigeria. Three hundred and twenty-four community volunteers completed a questionnaire and provided stool specimens for parasitology and microbiome analysis. Specimens were frozen and stored at -80°C. Of 324 subjects, 139 met criteria for average-risk CRC screening and had a stool sample for analysis. These were thawed and tested with a qualitative FIT. Specimens positive for occult blood were retested every two days to evaluate the impact of time and temperature on test performance. Of 139 individuals, 69 (49.6%) were positive for intestinal parasites and 10 (7.2%) were positive for occult blood. The most common pathogen was Cryptosporidium (40.6%). Among patients with intestinal parasites, 10.1% (7/69) had a positive FIT. Only 4.3% (3/70) of patients without parasites had a positive FIT (p = 0.208). On bivariate analysis, sociodemographic variables were not associated with a positive FIT result. Thirty percent (3/10) of the FIT-positive specimens became FIT-negative with routine storage. Although a positive FIT result was more common in those with parasitic infection, the relationship was not significant in this small cohort. The impact of high ambient temperature on test positivity may necessitate shorter processing time guidelines for equatorial countries. Additional prospective studies are needed to validate FIT performance in Nigeria.

Secular trend in interobserver agreement of VIA diagnosis for cervical cancer screening in Nigeria.

ObjectiveIn low resource settings, visual inspection with acetic acid (VIA) by allied health workers, has been suggested as an alternative for cervical cancer screening. However, there are concerns about the objectivity and time to diagnostic concordance with specialists. We evaluated the secular trend in interobserver agreement between nurse providers and a gynecologist/colposcopist over a five-year period.MethodsNurses provided VIA screening with digital cervivography to 4,961 participants in five screening clinics from October 2010 to May 2014 in Nigeria in this observational study. Cervigraphs were reviewed at meetings where a gynaecologist/colposcopist made an assessment from the cervigraphs. We used weighted kappa statistics to calculate agreement in diagnosis between nurse providers and the gynecologist/colposcopist; linear regression models to examine overall trend and investigate potential clinic characteristics that may influence agreement; and time series models to characterize month to month variations.ResultsMean age of participants was 37±8 years. Overall agreement was 0.89 at Site D, 0.78 and 0.73 at Sites A and C respectively, 0.50 for Site E and 0.34 for Site C. The number of trainings attended by nurse providers(β = 0.47,95%CI:0.02–0.93, p = 0.04), high level of engagement by site gynecologists(β = 0.11,95%CI:0.01–0.21,p = 0.04) were associated with increased agreement; while increasing distance from the coordinating site(β = -0.47,95%CI:-0.92–0.02,p = 0.04) was associated with decreased agreement. There were no associations between number of years screening clinics were operational(β = 0.01,95%CI: -0.01–0.03,p = 0.29), cumulative experience of nurse providers(β = 0.04,95%CI:-0.03–0.12,p = 0.19) and agreement. There were no significant increases in weighted kappa statistics over time for all sites considered. Monthly variations were significant for only one of two sites considered in time series models (AR1 term = -0.40, 95%CI:-0.71–0.09,p = 0.01).ConclusionOur results showed a lack of objectivity, persistent variation and lack of convergence of diagnostic capabilities of nurse led VIA cervical cancer screening with the diagnostic capabilities of a specialist in a cervical cancer screening program in Nigeria.

Establishment of Structured Preventive Mobile Cancer Care in Nigeria: A Success Story

Background and context: Mass medical mission is a nonprofit, public health charity aimed at complementing the effort of government in improving the health indices of Nigerians. Its core initiative is the National Cancer Prevention Program (NCPP), a foremost effort toward national cancer control in Nigeria. In 2007, NCPP spearheaded community-based mass cervical cancer screening in Nigeria, initially known as National Cervical Cancer Prevention Program (NCCPP). This effort has contributed to a 15% reduction of cervical cancer mortality in Nigeria, from 9659 deaths to 8240 deaths, between 2008 and 2012 (GLOBOCAN data). The improvement in cervical cancer survivorship in Nigeria was proof positive that winning the fight against cancer was possible if the effort could be scaled up. Consequently, mass medical mission escalated its advocacy drive, which was tagged the Big War Against Cancer in Nigeria. Aim: The short-term goal was to raise funds toward the provision one Mobile Cancer Centres (MCC) for each state and a Comprehensive Cancer Centre for each of the six geopolitical zones in the long-term. Strategy/Tactics: Mass medical mission initiated the establishment of a fundraising platform known as the Committee Encouraging Corporate Philanthropy (CECP-Nigeria). A private sector led initiative to promote concerted and synergistic philanthropy for the common good through public-social-private partnership. The President of Nigeria is the grand patron while the Vice President, the National Patron. Returns: Through this effort, four of the pilot set of MCC (known as PinkCruise) are now in Nigeria, one of which was donated by the Lagos State Governor. The fixed centers from which the PinkCruise operate have also been set up in four selected cities representing the four old regions of Nigeria. These mobile units are unique as they are multifunctional with state-of-the-art facilities for screening, follow-up and treatment (including mammography, endoscopy, colonoscopy, colposcopy, cryotherapy, laboratory, vaccination and surgeries for precancer and early cancer). The PinkCruise have been deployed to carry out systematic mobile health outreaches, known as Mission PinkCruise, which also have an eye-care aspect known as Mission PinkVISSION. PinkVISSION is also an initiative of mass medical mission (mmm), aimed at achieving the goals of “Vision 2020: The Right to Sight”, by incorporating preventive eye care into cancer prevention and general health promotion. The acronym, VISSION, stands for Voluntary Integrated Sight Saving Initiative Of Nigeria. Both Mission PinkCruise and Mission PinkVISSION are free of charge to the hosts and the beneficiaries. What was learned: The synergy between PinkVISSION and PinkCruise results in improved uptake, impact and cost effectiveness of both the cancer campaign and the eye campaign.

Screen and Triage by Community Extension Workers to Facilitate Screen and Treat: Task-Sharing Strategy to Achieve Universal Coverage for Cervical Cancer Screening in Nigeria.

PurposeUniversal coverage of cervical cancer screening remains elusive in most low- and middle-income countries (LMICs), home to the greatest burden of this preventable disease. Implementation of a cytology-based screening strategy in these countries is challenging. Also, there is shortage of health care workers (HCWs) to implement the low-technology, cheaper, but equally effective, methods like visual inspection with acetic acid. However, the implementation of HIV programs in LMICs has introduced the innovation of task shifting and task sharing, using the community health extension workers (CHEWs) and community health officers (CHOs) to complement clinical HCWs, especially at the primary health care, level with good outcome. Hence, this study leveraged this strategy.MethodsWe piloted a study to improve knowledge and practice skills of CHEWs and CHOs in a rural community of Oyo state, Nigeria, through training and participatory supervision to screen for cervical cancer using visual inspection with acetic acid and link positive cases for treatment with cryotherapy.ResultsA total of 51 HCWs, including doctors, nurses, CHEWs, and CHOs, were trained during the study to provide cervical cancer screening services. After the training, cervical cancer and its prevention knowledge improved from 52.4% before training to 91.5% immediate after training. Over 12 months, 950 eligible women were screened, of whom 848 (89.3%) were screened by CHEWs and CHOs. Of the 63 rescreened by CHEWs and CHOs (data grouped), and nurses, 88.1% and 92.3%, respectively, agreed with expert team review, with κ statistics of 0.76 and 0.84, respectively.ConclusionThis pilot project showed the ability of CHEWs and CHOs to identify cervical dysplasia was good and that of nurses was very good with appropriate competency training to achieve universal coverage of cervical cancer screening in LMICs.

Screen and Triage to Facilitate Screen and Treat by Community Health Extension Workers: Task-Sharing Strategy to Achieve Universal Cervical Cancer Screening in Nigeria

Abstract 31 Purpose Universal access to cervical cancer screening remains elusive in most low- to middle-income countries, which shoulder the greatest burden of this preventable disease. Whereas a cytology-based screening strategy is logistically impossible, the shortage of health care workers (HCWs) and appropriate training limit the implementation of cheaper and equally effective methods, such as visual inspection after application of acetic acid (VIA); however, effective use of task shifting and sharing to involve community health extension workers (CHEWs) in HIV program delivery in low- to middle-income countries has brought innovation to bear in overcoming the HCW shortage. Hence, this study leveraged this novel strategy to pilot the provision of cervical cancer screening by CHEWs in Nigeria. The current study aimed to train and support the available health care workforce in rural communities to achieve population coverage for cervical cancer screening and reduce the cervical cancer burden in Nigeria. Methods We piloted improving the knowledge and practice skills of CHEWs/CHOs in a rural local government area of Oyo state, Nigeria, to provide community-level cervical cancer screening service. Improvement in knowledge and skills was accomplished through training, technical and infrastructural support, and participatory supervision for HCWs in the PHCs and general hospital in the local government area using the VIA method and by linking VIA-positive cases to the general hospital to screen and treat. Results Fifty-one HCWs, including physicians, nurses, and CHEWs/CHOs, were trained with five PHCs, and the general hospital was provided with materials with which to administer cervical cancer screening services. Participants’ knowledge improved from an average of 50.5% at pretraining to 88.8% immediately post-training. Of the 950 eligible women who were screened in 1 year, 848 (89.3%) were screened by CHEWs/CHOs. Of the 66 who were screened as VIA positive by CHEWs/CHOs, 58 (88.1%) agreed with the supervisory team review compared with 18 (92.3%) of 19 who were screened by nurses (κ statistics, 0.84 and 0.76, respectively). Three cases of invasive cervical cancer were diagnosed during this period, two of which were by CHEWs/CHOs. Conclusion This pilot project demonstrated that, with appropriate competency training and necessary support, CHEWs/CHOs can successfully identify cervical dysplasia. These HCWs are important resources to leverage to achieve universal coverage of cervical cancer screening services in Nigeria. We plan to expand this program to involve the seven health zones in Oyo state, Nigeria, in a hub and spoke manner to establish its wider feasibility. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

Randomized trial evaluating self-sampling for HPV DNA based tests for cervical cancer screening in Nigeria

BackgroundCervical cancer incidence and mortality rates in Sub-Saharan Africa (SSA) remain high due to several factors including low levels of uptake of cervical cancer screening. Self-collection of cervicovaginal samples for HPV DNA testing may be an effective modality that can increase uptake of cervical cancer screening in SSA and hard to reach populations in developed countries. We investigated whether self-collection of cervicovaginal samples for HPV DNA tests would be associated with increased uptake of screening compared with clinic based collection of samples. Furthermore, we compared the quality of samples collected by both approaches for use in HPV genotyping.MethodsWe conducted a community based randomized trial in a semi-urban district of Abuja, Nigeria with 400 women, aged 30 to 65 years randomized to either hospital-collection or self-collection of cervicovaginal samples. We compared cervical cancer screening uptake among the 2 groups and evaluated the concentration of human DNA in the samples by measuring RNase P gene levels using qPCR. High-risk HPV DNA detection and typing was done using the GP5+/6+ Luminex system.ResultsMost participants in the self-collection arm (93%, 185/200) submitted their samples while only 56% (113/200) of those invited to the hospital for sample collection attended and were screened during the study period (p value < 0.001). Human genomic DNA was detected in all but five (1.7%) participants, all of whom were in the self-collection arm. The prevalence of high-risk HPV in the study population was 10% with types 35, 52 and 18 being the commonest.ConclusionsOur study shows that self-sampling significantly increased uptake of HPV DNA based test for cervical cancer screening in this population and the samples collected were adequate for HPV detection and genotyping. Cervical cancer screening programs that incorporate self-sampling and HPV DNA tests are feasible and may significantly improve uptake of cervical cancer screening in SSA.

Exploring the Barriers to Breast and Cervical Cancer Screening in Nigeria: A Narrative Review.

Breast and cervical cancers are the most common causes of female cancer-related mortality in Nigeria. Early detection and treatment significantly decreases cancer mortality rates. Various factors influence uptake of cancer screening. Cancer awareness, availability of screening, and treatment facilities alone have not been completely successful in improving cancer health behaviour. This review aims to identify and summarise the barriers to breast and cervical cancer screening uptake in Nigeria. Various databases such as PubMed, Psych Info, Google Scholar and EMBASE were extensively searched for existing literature on factors influencing breast and cervical cancer screening in Nigeria. Studies retrieved explored the major socioeconomic factors affecting women's knowledge, perception, and attitude. Embarrassment, low perception of cancer risk, and physician gender preference are some of the most common factors that discouraged women from cancer screening. Lack of spouse permission and support; belief that cancer is a death wish, and societal discrimination are the common sociocultural barriers to screening. These factors vary across different regions in Nigeria. Therefore, policy makers should make deliberate effort to develop cancer management strategies that are tailored to the sociocultural and religious needs in a target population. This approach is anticipated to improve uptake and ensure sustainability of cancer management.

A vision for improved cancer screening in Nigeria.

A vision for improved cancer screening in Nigeria.

Risk factors and distribution of oncogenic strains of human papilloma virus in women presenting for cervical cancer screening in Port Harcourt, Nigeria

INTRODUCTION: human papilloma virus(HPV) accounts for most cases of cervical cancer with high risk HPV(hrHPV) genotypes largely responsible. The objective is to ascertain the distribution of oncogenic strains of human papilloma virus genotypes and predisposing risk factors in women presenting for cervical cancer screening in Nigeria. METHODS: a cross-sectional study of 80 women who presented for cervical cancer screening. The biodata of the participants, the presence of risk factors to HPV were recorded and hrHPV were identified using PCR technique. The information obtained was processed using the SPSS version 20 software. Results were presented in tables, test of significance and association done using student's t-test and Odds ratio with P value < 0.05 as significant. RESULTS: the age range of patients was 19-62 years with prevalence of hrHPV of 10%. HrHPV are more in patients with more than one life time sexual partner (OR 1.26,95%CI 0.13-29.99), multiple sexual partners (OR 1.55, 95% CI 0.28-8.70), early coitarche (OR 1.57, 95% CI 0.14-15.00) and previous STI (OR 150, 95%CI 9.53-1979. 62). Four hrHPV genotypes: 16, 18, 31 and 35 were detected. CONCLUSION: HPV genotype 18 was predominant in Port Harcourt, Nigeria. High risk sexual behaviours are associated with acquisition of hrHPV.

Analysis of the Determinants of Low Cervical Cancer Screening Uptake Among Nigerian Women.

Cervical cancer causes an estimated 266,000 deaths globally, 85% of which occurs in developing countries. It is a preventable disease, if detected and treated early via screen and treat, yet its burden is still huge in Nigeria. In 2012, 21.8% cases of cervical cancer and 20.3% deaths due to cervical cancer were recorded in Nigeria. This review, therefore, aims at indentifying the determinants of low cervical cancer screening in Nigeria in order to contribute in reducing the burden of the disease. Literature were obtained from Global Health, Popline and PubMed databases; WHO and other relevant websites using Eldis search engine; and from libraries in the University of Leeds and WHO in Geneva. Conceptual framework for analyzing the determinants of cervical cancer screening uptake among Nigerian women was formed by inserting service delivery component of the WHO health system framework into a modified Health Belief Model. Wrong perception of cervical cancer and cervical cancer screening due to low level of knowledge about the disease and inadequate cervical cancer prevention were identified as the major determinants of low cervical cancer screening uptake in Nigeria. Among women, belief in being at risk and/or severity of cervical cancer was low just as belief on benefits of cervical cancer screening, unlike high belief in barriers to screening. Support from the community and screening skills among health-workers were inadequate. Improving uptake of cervical cancer screening will reduce the burden of the disease. Therefore, researchers and other stakeholders interested in prevention of cervical cancer should carryout studies to identify interventions that could address the key determinants of low cervical cancer screening among Nigerian women.