Understanding of Cervical Cancer and Predictors of Cervical Screening Seeking Behaviour Among Women in Gombe State, Nigeria.

Abstract

Introduction: Cervical cancer affects women worldwide. However, Sub-Saharan Africa bears the highest burden of the disease due to factors including poor knowledge, unavailability of services, and a high burden of HIV infection. These factors can affect access and uptake of cervical cancer screening for women in this region. The objective of this study was to assess the understanding of cervical cancer and cervical screening-seeking behaviour of women in Gombe State, Nigeria.

Method: A community-based cross-sectional survey of 2,158 women aged 18-70 years, attending a community health facility, was carried out from October – December 2019; questionnaires drew on available evidence and underwent pre-testing and refinement. Descriptive statistics, bivariate analysis and binary logistic regression were used to analyse and summarise data. We considered statistically significant associations at p ≤ 0.025.

Results: 85% of women had no awareness of cervical cancer. Among the 15% with awareness, less than 30% had basic knowledge of cervical cancer. We examined four main outcomes affecting cervical screening-seeking behaviour and associated predictors.

1) “Having the intention to screen for cervical cancer”, 27.7%; awareness of cervical screening (AOR = 94.58; 95%CI: 11.90-751.88; p=0.000) and prefer to self-screen at home (AOR = 0.23; 95%CI: 0.10-0.57; p=0.001).

2) “Needed permission to get screening”, 76.8%; Married (AOR = 2.31; 95% CI: 1.28-4.20; p=0.006), Muslim faith (AOR = 2.99; 95%CI: 1.63-5.47; p=0.000), and poor knowledge of cervical cancer (AOR = 1.89; 95%CI: 1.05-3.40; p=0.002).

3) “Prefer to be accompanied to the place of screening”, 55.8%; Muslim faith (AOR = 2.37; 95%CI: 1.36-4.12; p=0.002) and unscreened due to unaware/unavailable services (AOR = 1.90; 95%CI: 1.16-3.11; p=0.011).

4) “Having gender preference for health worker”, 44.0%; Married (AOR = 2.06; 95%CI: 1.10- 3.83; p=0.023), awareness of cervical screening (AOR = 2.35; 95%CI: 1.33-4.16; p=0.003), unscreened due to unaware/unavailable services (AOR = 2.33; 95%CI: 1.40-3.90; p=0.001).

Conclusions: Implementation of cervical screening services should prioritise awareness raising and integrate cultural values and practices of the community.