Awareness and Knowledge of Cervical Cancer and Uptake of Cervical Cancer Screening among Women in Rayfield Ward, Jos South, Plateau State

About 85% of cervical cancer deaths globally occur in developing or underdeveloped nations, and the death rate is 18 times greater in low- and middle-income nations compared to affluent nations. The introduction of effective screening programs has led to a significant reduction in cervical cancer incidence and mortality rates. Hence, Background: The majority of cervical cancer deaths worldwide occur in low- and middle-income countries, with mortality rates significantly higher than in high-income settings. Effective screening programs have reduced incidence and mortality in developed countries. This study assessed awareness, knowledge, and uptake of cervical cancer screening services among women in Rayfield Ward, Jos South LGA, Plateau State, Nigeria, using the Health Belief Model and Anderson's Behavioural Model as frameworks.
A descriptive cross-sectional survey was conducted among 530 women, with 493 valid responses analysed. Data were collected via structured, interviewer-administered questionnaires covering sociodemographics, awareness, knowledge, and screening practices. Descriptive and inferential statistics were used for analysis.
Awareness of cervical cancer and screening services was high, but knowledge gaps and misconceptions persisted. Only 28.6% of respondents reported ever undergoing screening. Sociology-demographic variables, including education and income, were not significantly associated with screening uptake (p > 0.05 for all variables). Many respondents expressed willingness to be screened in future.
While awareness and knowledge levels were moderate to high, screening uptake was low. Barriers included cost, fear, and gender preference for female health workers. Strengthened education, subsidised programs, and gender-sensitive service provision are recommended to improve uptake.

Cervical cancer, awareness, screening uptake, knowledge, barriers

1. Abotchie, P. N., & Shokar, N. K. (2009). Cervical cancer screening among college students in Ghana: Knowledge and health beliefs. International Journal of Gynecologic Cancer, 19(3), 412–416. https://doi.org/10.1111/IGC.0b013e3181a1d6de [Google Scholar] [Crossref]

2. Abugu, L. I., & Nwagu, E. N. (2021). Awareness, knowledge and screening for cervical cancer among women of a faith-based organization in Nigeria. The Pan African medical journal, 39, 200. https://doi.org/10.11604/pamj.2021.39.200.23761 [Google Scholar] [Crossref]

3. Akor, O. (2025). ’60 million women in Nigeria at risk of developing cervical. Daily Trust. https://dailytrust.com/60-million-women-in-nigeria-at-risk-of-developing-cervical-cancer/ [Google Scholar] [Crossref]

4. Al-Ani, A., Hammouri, M., Sultan, H., & Al-Huneidy, L. (2023). Factors affecting cervical screening using the health belief model during the last decade: A systematic review and meta‐analysis. Psycho‐Oncology, 33(1). https://doi.org/10.1002/pon.6275 [Google Scholar] [Crossref]

5. Aljunid, S. M., Zafar, A., & Saperi, S. (2010). Burden of disease associated with cervical cancer in Malaysia and potential costs and consequences of HPV vaccination. Asian Pacific Journal of Cancer Prevention, 11(6), 1551–1559. [Google Scholar] [Crossref]

6. Alkhawaldeh, A., ALBashtawy, M., Rayan, A., Abdalrahim, A., Musa, A., Eshah, N., Abu Khait, A., Qaddumi, J., Khraisat, O., & ALBashtawy, S. (2023). Application and use of Andersen’s behavioral model as theoretical framework: A systematic literature review from 2012–2021. Iran Journal of Public Health, 52(7), 1346–1354. http://ijph.tums.ac.ir [Google Scholar] [Crossref]

7. Al-Shaikh, G. K., Almussaed, E. M., Fayed, A. A., Khan, F. H., Syed, S. B., Al-Tamimi, T. N., ... & Al-Mandeel, H. M. (2014). Knowledge of Saudi female university students regarding cervical cancer and acceptance of the human papilloma virus vaccine. Saudi Medical Journal, 35(10), 1223–1230. [Google Scholar] [Crossref]

8. Alves, G., Herkrath, F., Parente, R., & Vettore, M. (2025). Utilisation of medical healthcare services among elderly people living in a rural Amazonian community, Brazil: A cross-sectional study [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-6228076/v1 [Google Scholar] [Crossref]

9. Alyafei, A., & Easton-Carr, R. (2024, May 19). The Health Belief Model of behavior change. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK606120/ [Google Scholar] [Crossref]

10. Anyasi H. I. and Foss A. M. (2021) A comparative analysis of cervical cancer prevention between Nigeria and Nordic countries that have experienced a decline in cervical cancer incidence. Int health;13(4):307-317. doi: 10.1093/inthealth/ihaa062. [Google Scholar] [Crossref]

11. Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J., & Bray, F. (2020). Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. The Lancet. Global health, 8(2), e191–e203. https://doi.org/10.1016/S2214-109X(19)30482-6 [Google Scholar] [Crossref]

12. Asempah, E., & Wiktorowicz, M. E. (2023). Understanding HPV Vaccination Policymaking in Rwanda: A Case of Health Prioritization and Public-Private-Partnership in a Low-Resource Setting. International Journal of Environmental Research and Public Health, 20(21), 6998. https://doi.org/10.3390/ijerph20216998 [Google Scholar] [Crossref]

13. Asogun, D., Alenoghena, I. & Egbefere, H. (2024). Knowledge, Attitude and Practice of Cervical Cancer Screening among Reproductive Age Group Women in Ekpoma, South-South Nigeria. The Nigerian Health Journal, 24(3), 1566-1576. https://doi.org/10.60787/tnhj.v24i3.881 [Google Scholar] [Crossref]

14. Ayenew, A. A., Zewdu, B. F., & Nigussie, A. A. (2020). Uptake of cervical cancer screening service and associated factors among age-eligible women in Ethiopia: Systematic review and meta-analysis. Infectious Agents and Cancer, 15(1), 67. https://doi.org/10.1186/s13027-020-00334-3 [Google Scholar] [Crossref]

15. Barley, E., & Lawson, V. (2016). Using health psychology to help patients: Theories of behaviour change. British Journal of Nursing, 25(16), 924–927. https://doi.org/10.12968/bjon.2016.25.16.924 [Google Scholar] [Crossref]

16. Basu P., Mittal S., Bhadra V. D. & Chami K. Y. (2018). Secondary prevention of cervical cancer. Best Pract Res Clin Obstetr Gynaecol. 47:73–85. 10.1016/j.bpobgyn.2017.08.012 [Google Scholar] [Crossref]

17. Braaten, K. P., & Laufer, M. R. (2008). Human papillomavirus (HPV), HPV-related disease, and the HPV vaccine. Reviews in Obstetrics and Gynecology, 1(2), 2–10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505271/ [Google Scholar] [Crossref]

18. Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 68(6), 394–424. https://doi.org/10.3322/caac.21492 [Google Scholar] [Crossref]

19. Catalan Institute of Oncology (ICO) & International Agency for Research on Cancer (IARC). (2023). Nigeria: Human papillomavirus and related cancers, fact sheet 2023. HPV Information Centre. https://hpvcentre.net/Cervical Cancer Free Coalition. (2017). Cervical cancer global crisis card. [Google Scholar] [Crossref]

20. Chirwa G. C. (2022). Explaining socioeconomic inequality in cervical cancer screening uptake in Malawi. BMC public health, 22(1), 1376. https://doi.org/10.1186/s12889-022-13750-4 [Google Scholar] [Crossref]

21. City Population. (2022). Jos South (Local Government Area, Plateau State, Nigeria) – population statistics, charts and map. Retrieved July 16, 2025, from https://citypopulation.de/en/nigeria/admin/plateau/NGA032006__jos_south/ [Google Scholar] [Crossref]

22. Cochran, W. G. (1977). Sampling techniques (3rd ed.). New York: John Wiley & Sons. [Google Scholar] [Crossref]

23. Cohen P. A., Jhingran A., Oaknin A. and Denny L. (2019). Cervical cancer. Lancet;393(10167):169‐182. [Google Scholar] [Crossref]

24. Danladi, A., Atu, D., Gwom, M., & Musa Magaji, J. (2024). Determinants of the uptake of cervical cancer screening among women in Jos North, Plateau State: Implication for social inclusivity. https://doi.org/10.22624/AIMS/ACCRACROSSBORDER2023P25 [Google Scholar] [Crossref]

25. Daru, P. H., Obikili, C. G., Silas, O. A., Musa, J., Shambe, I. H., Magaji, F. A., Adesina, B., & Adewole, I. F. (2021). A decade of cervical cancer screening at the Jos University Teaching Hospital. Tropical Journal of Obstetrics & Gynaecology. [Google Scholar] [Crossref]

26. del Pino, M., Vorsters, A., Joura, E. A., Doorbar, J., Haniszewski, M., Asensio Gudina, I., Kodjamanova, P., Velicer, C., & Drury, R. (2024). Risk factors for human papillomavirus infection and disease: A targeted literature summary. Journal of Medical Virology, 96(2), e29420. https://doi.org/10.1002/jmv.29420 [Google Scholar] [Crossref]

27. Desta M, Getaneh T, Yeserah B, Worku Y, & Eshete T. (2023) Correction: Cervical cancer screening utilization and predictors among eligible women in Ethiopia: A systematic review and meta-analysis. PLOS ONE 18(11): e0294799. https://doi.org/10.1371/journal.pone.0294799 View correction [Google Scholar] [Crossref]

28. Duncan, K., Cira, M. K., Barango, P., and Trimble, E. L. (2019). Challenges and opportunities in the creation and implementation of cancer-control plans in Africa. Ecancermedicalscience, 13, 938. https://doi.org/10.3332/ecancer.2019.938 [Google Scholar] [Crossref]

29. Dung, D. G., Mamman, S. M., & Magaji, J. M. (2024). Socio-cultural factors influencing the practice of cervical cancer screening among women in antenatal and postnatal clinic in Dalhatu Araf Specialist Hospital Lafia, Nasarawa State, Nigeria. African Journal of Social and Behavioural Sciences, 14(8), Article 4450. HTTP://doi.org/10.36349/AJSBS.2024.v14i8.4450 [Google Scholar] [Crossref]

30. Ehwarieme, T. A., & Elusoji, C. I. (2025). Prevalence and Associated Risk Factors of Cervical Cancer Among Women in a Nigerian Cohort. Annals of Biomedical and Health Sciences, 3(1). https://journals.lww.com/abhs [Google Scholar] [Crossref]

31. Elton, L. (2021). Non-maleficence and the ethics of consent to cancer screening; Journal of Medical Ethics; 47:510-513. [Google Scholar] [Crossref]

32. Eun, T. J., & Perkins, R. B. (2020). Screening for Cervical Cancer. The Medical clinics of North America, 104(6), 1063–1078. https://doi.org/10.1016/j.mcna.2020.08.006 [Google Scholar] [Crossref]

33. Ezenkwa, U. S., Katagum, D. A., Achanya, S. E., Olayinka, H. T., Muhammad, Z., Muhammed, A. O., Abubakar, N., Kadaura, M. U., George, S. H. L., Schlumbrecht, M., & Audu, B. M. (2024). Divergence between awareness and uptake of cervical cancer screening among healthcare workers: A single centre experience in Northeastern Nigeria. FUHSA-UM International Convening in Research and Collaboration, 1(Suppl). [Google Scholar] [Crossref]

34. Federal Ministry of Health and Social Welfare (Nigeria). (2025). National Cancer Control Programme. Retrieved July 2025, from Federal Ministry of Health website: https://health.gov.ng/national-cancer-control-programme/ [Google Scholar] [Crossref]

35. Feldstein, O., Gali-Zamir, H., Schejter, E., Feinberg, T., Yehuda-Shnaidman, E., Bornstein, J., & Levy, T. (2023). High-risk HPV testing vs liquid-based cytology for cervical cancer screening among 25- to 30-year-old women: A historical cohort study. Acta Obstetricia et Gynecologica Scandinavica, 102(2), 226–233. https://doi.org/10.1111/aogs.14482 [Google Scholar] [Crossref]

36. Ferlay J, Colombet M. & Soerjomataram I. (2018). Global and Regional Estimates of the Incidence and Mortality for 38 Cancers: GLOBOCAN 2018. Lyon: International Agency for Research on Cancer/World Health Organization. [Google Scholar] [Crossref]

37. Fitzpatrick, M., Pathipati, M. P., McCarty, K., Rosenthal, A., Katzenstein, D., Chirenje, Z. M., and Pinsky, B. (2020). Knowledge, attitudes, and practices of cervical Cancer screening among HIV-positive and HIV-negative women participating in human papillomavirus screening in rural Zimbabwe. BMC women's health, 20(1), 153. https://doi.org/10.1186/s12905-020-01017-2 [Google Scholar] [Crossref]

38. Francis, S. A., Nelson, J., Liverpool, J., Soogun, S., Mofammere, N., & Thorpe, R. J. (2010). Examining attitudes and knowledge about HPV and cervical cancer risk among female clinic attendees in Johannesburg, South Africa. Vaccine, 28(50), 8026–8032. https://doi.org/10.1016/j.vaccine.2010.09.089 [Google Scholar] [Crossref]

39. Gafaranga, J. P., Manirakiza, F., Ndagijimana, E., Urimubabo, J. C., Karenzi, I. D., Muhawenayo, E., Gashugi, P. M., Nyirasebura, D., & Rugwizangoga, B. (2022). Knowledge, Barriers and Motivators to Cervical Cancer Screening in Rwanda: A Qualitative Study. International journal of women's health, 14, 1191–1200. https://doi.org/10.2147/IJWH.S374487 [Google Scholar] [Crossref]

40. Gamde, M. S., Adeleye, T. M., & Adisa, J. O. (2024). Review on histopathological techniques in cervical cancer screening. Asian Pacific Journal of Cancer Care, 9(4), 785–791. https://doi.org/10.31557/apjcc.2024.9.4.785-791 [Google Scholar] [Crossref]

41. Giuliano, A. R., Isaacs-Soriano, K., Torres, B. N., Abrahamsen, M., Ingles, D. J., & Sirak, B. A. (2015). Immunogenicity and safety of Gardasil among mid-adult aged men (27–45 years) – The MAM study. Vaccine, 33(42), 5640–5646. https://doi.org/10.1016/j.vaccine.2015.08.072 [Google Scholar] [Crossref]

42. Hosseini, Z., Seyrafi, N., Homayuni, A., Mouseli, A., & Homayuni, A. (2023). Predicting cervical cancer screening behavior among women in southern Iran: a cross-sectional study with PEN-3 model. BMC women's health, 23(1), 260. https://doi.org/10.1186/s12905-023-02416-x [Google Scholar] [Crossref]

43. International Agency for Research on Cancer (IARC). (2022). Nigeria: GLOBOCAN 2022 Fact Sheet. Retrieved from https://gco.iarc.fr/today/data/factsheets/populations/566-nigeria-fact-sheets.pdf [Google Scholar] [Crossref]

44. Jain, N., Irwin, K. L., Montano, D. E., Kasprzyk, D., Carlin, L., Freeman, C., & Fishbein, M. (2009). Human papillomavirus (HPV) awareness and vaccination initiation among women in the United States: National Immunization Survey–Adult 2007. Preventive Medicine, 48(5), 426–431. https://doi.org/10.1016/j.ypmed.2009.02.008 [Google Scholar] [Crossref]

45. John-Akinola, Y. O., Ndikom, C. M., Oluwasanu, M. M., Adebisi, T., and Odukoya, O. (2022). Cervical Cancer and Human Papillomavirus Vaccine Knowledge, Utilisation, Prevention Educational Interventions and Policy Response in Nigeria: A Scoping Review. Cancer control: journal of the Moffitt Cancer Center, 29, 10732748221130180. https://doi.org/10.1177/10732748221130180 [Google Scholar] [Crossref]

46. Kahn, J. A., Rosenthal, S. L., Hamann, T., & Bernstein, D. I. (2003). Attitudes about human papillomavirus vaccine in young women. International Journal of STD & AIDS, 14(5), 300–306. https://doi.org/10.1258/095646203765371721 [Google Scholar] [Crossref]

47. Karjane, N. W. (2024). Cervical cytology (Pap smear). Medscape. https://emedicine.medscape.com/article/1947979-overview#a1 [Google Scholar] [Crossref]

48. Kayode, O. O., Alabi, Q. K., Adedoyin, F. F., Olarinmoye, T. A., Ekwonwa, E., & Ogenma, U. (2020). Awareness, knowledge and uptake of cervical cancer screening among women of reproductive age in selected wards in Ede South Local Government Area, Osun State. East African Scholars Journal of Medical Sciences, 3(8), 325. https://doi.org/10.36349/EASMS.2020.v03i08.006 [Google Scholar] [Crossref]

49. Khoo, C. L., Teoh, S., Rashid, A. K., Zakaria, U. U., Mansor, S., Salleh, F. N. M., & Nawi, M. N. M. (n.d.). Awareness of cervical cancer and HPV vaccination and its affordability among rural folks in Penang, Malaysia. Research Communication. [Google Scholar] [Crossref]

50. Lederle, M., Tempes, J., & Bitzer, E. M. (2021). Application of Andersen’s behavioural model of health services use: A scoping review with a focus on qualitative health services research. BMJ Open, 11, e045018. https://doi.org/10.1136/bmjopen-2020-045018 [Google Scholar] [Crossref]

51. Li, J., Kang, L. N., & Qiao, Y. L. (2009). Review of the cervical cancer burden and prevention strategies in China. Asian Pacific Journal of Cancer Prevention, 10(1), 1–4. [Google Scholar] [Crossref]

52. Lim, T. S. C., Ismail-Pratt, I., & Goh, L. H. (2022). Cervical cancer screening and vaccination: Understanding the latest guidelines. Singapore Medical Journal, 63(3), 125–129. https://doi.org/10.11622/smedj.2022045 [Google Scholar] [Crossref]

53. Luna, J., Plata, M., Gonzalez, M., Correa, A., Maldonado, I., Nossa, C., ... & Villa, L. L. (2013). Long-term follow-up observation of the safety, immunogenicity, and effectiveness of Gardasil™ in adult women. PLoS ONE, 8(12), e83431. https://doi.org/10.1371/journal.pone.0083431 [Google Scholar] [Crossref]

54. Lyimo, F. S., & Beran, T. N. (2012). Determinants of health care seeking behavior in cervical cancer screening among women in Tanzania. BMC Health Services Research, 12(22). https://doi.org/10.1186/1472-6963-12-22 [Google Scholar] [Crossref]

55. Mafiana, J. J., Dhital, S., Halabia, M., & Wang, X. (2022). Barriers to uptake of cervical cancer screening among women in Nigeria: a systematic review. African health sciences, 22(2), 295–309. https://doi.org/10.4314/ahs.v22i2.33 [Google Scholar] [Crossref]

56. Mafiana, J. J., Dhital, S., Halabia, M., & Wang, X. (2022). Barriers to uptake of cervical cancer screening among women in Nigeria: a systematic review. African health sciences, 22(2), 295–309. https://doi.org/10.4314/ahs.v22i2.33 [Google Scholar] [Crossref]

57. Mantula, F., Toefy, Y., & Sewram, V. (2024). Barriers to cervical cancer screening in Africa: a systematic review. BMC public health, 24(1), 525. https://doi.org/10.1186/s12889-024-17842-1 [Google Scholar] [Crossref]

58. Mantula, F., Toefy, Y., & Sewram, V. (2024). Barriers to cervical cancer screening in Africa: a systematic review. BMC public health, 24(1), 525. https://doi.org/10.1186/s12889-024-17842-1 [Google Scholar] [Crossref]

59. Meites, E., Szilagyi, P. G., Chesson, H. W., Unger, E. R., Romero, J. R., & Markowitz, L. E. (2019). Human papillomavirus vaccination for adults: Updated recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report (MMWR), 68(32), 698–702. https://doi.org/10.15585/mmwr.mm6832a3 [Google Scholar] [Crossref]

60. Mekuria, S. F., Biazin, H., Abebe, T., Nemomsa, R. O., Forslund, O., & Jerkeman, M. (2024). Comparing visual inspection with acetic acid, with and without Lugol’s iodine for triage of HPV self-sample positive women in Ethiopia: A randomized controlled trial. International Journal of Gynecological Cancer, 34(11), 1691–1697. https://doi.org/10.1016/j.ijgc.2024.03594 [Google Scholar] [Crossref]

61. Mendagudli, V. G., & Sarawad, S. S. (2021). Cervical cancer - An overview. International Journal of Creative Research Thoughts, 9(4), 2128. https://www.ijcrt.org/IJCRT2104270.pdf [Google Scholar] [Crossref]

62. Moshi, F. V., Bago, M., Ntwenya, J., Mpondo, B., & Kibusi, S. M. (2019). Uptake of cervical cancer screening services and its association with cervical cancer awareness and knowledge among women of reproductive age in Dodoma, Tanzania: A cross-sectional study. East African Health Research Journal, 3(2), 105–114. https://doi.org/10.24248/EAHRJ-D-19-00006 [Google Scholar] [Crossref]

63. Mwaka, A. D., Orach, C. G., Were, E. M., Lyratzopoulos, G., Wabinga, H., & Roland, M. (2016). Awareness of cervical cancer risk factors and symptoms: cross-sectional community survey in post-conflict northern Uganda. Health expectations : an international journal of public participation in health care and health policy, 19(4), 854–867. https://doi.org/10.1111/hex.12382 [Google Scholar] [Crossref]

64. Nainakshi, K., Nadiya, K., Sukhpal, K., & Sandhya, G. (2019). Risk factors of cervical cancer: A case-control study. Asia-Pacific Journal of Oncology Nursing, 6(3), 308–314. https://doi.org/10.4103/apjon.apjon_73_18 [Google Scholar] [Crossref]

65. National Cancer Institute. (2024). Cervical cancer prevention (PDQ®)–patient version. National Institutes of Health. Retrieved July 16, 2025, from https://www.cancer.gov/types/cervical/causes-risk-prevention#:~:text=HPV%20infection%20causes%20cervical%20cancer,cancers%2C%20see%20HPV%20and%20Cancer [Google Scholar] [Crossref]

66. Nigeria Demographic and Health Survey (2018). Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF. Retrieved from: https://dhsprogram.com/pubs/pdf/FR359/FR359.pdf [Google Scholar] [Crossref]

67. Nyblade, L., Ndirangu, J. W., Speizer, I. S., Browne, F. A., Bonner, C. P., Minnis, A., Kline, T. L., Ahmed, K., Howard, B. N., Cox, E. N., Rinderle, A., and Wechsberg, W. M. (2022). Stigma in the health clinic and implications for PrEP access and use by adolescent girls and young women: conflicting perspectives in South Africa. BMC public health, 22(1), 1916. https://doi.org/10.1186/s12889-022-14236-z [Google Scholar] [Crossref]

68. Ogundipe, L., Ojo, T., Oluwadare, T., Olayemi, E., Oluwafemi, F., Oni, O., Kukoyi, O., & Orok, E. (2023). Cervical cancer screening and vaccination: knowledge, awareness, and attitude of female staff in a Nigerian University. BMC women's health, 23(1), 218. https://doi.org/10.1186/s12905-023-02345-9 [Google Scholar] [Crossref]

69. Oketch, S. Y., Ochomo, E. O., Orwa, J. A., Mayieka, L. M. & Abdullahi, L. H. (2023). Communication strategies to improve human papillomavirus (HPV) immunisation uptake among adolescents in sub-Saharan Africa: a systematic review and meta-analysis. BMJ open, 13(4), e067164. https://doi.org/10.1136/bmjopen-2022-067164 [Google Scholar] [Crossref]

70. Okolie, E. A., Aluga, D., Anjorin, S., Ike, F. N., Ani, E. M. & Nwadike, B. I. (2022). Addressing missed opportunities for cervical cancer screening in Nigeria: a nursing workforce approach. Ecancermedicalscience, 16, 1373. https://doi.org/10.3332/ecancer.2022.1373 [Google Scholar] [Crossref]

71. Okolie, E. A., Aluga, D., Anjorin, S., Ike, F. N., Ani, E. M., & Nwadike, B. I. (2022). Addressing missed opportunities for cervical cancer screening in Nigeria: a nursing workforce approach. Ecancermedicalscience, 16, 1373. https://doi.org/10.3332/ecancer.2022.1373 [Google Scholar] [Crossref]

72. Oleribe, O. O., Momoh, J., Uzochukwu, B. S., Mbofana, F., Adebiyi, A., Barbera, T., Williams, R., & Taylor-Robinson, S. D. (2019). Identifying Key Challenges Facing Healthcare Systems In Africa And Potential Solutions. International journal of general medicine, 12, 395–403. https://doi.org/10.2147/IJGM.S223882 [Google Scholar] [Crossref]

73. Olorunfemi, G., Ndlovu, N., Masukume, G., Chikandiwa, A., Pisa, P. T., and Singh, E. (2018). Temporal trends in the epidemiology of cervical cancer in South Africa (1994-2012). International journal of cancer, 143(9), 2238–2249. https://doi.org/10.1002/ijc.31610 [Google Scholar] [Crossref]

74. Olubodun, T., Balogun, M. R., Odeyemi, A. K., Odukoya, O. O., Ogunyemi, A. O., Kanma-Okafor, O. J., Okafor, I. P., Olubodun, A. B., Ogundele, O. O. P., Ogunnowo, B. & Osibogun, A. (2022). Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study. BMC public health, 22(1), 1906. https://doi.org/10.1186/s12889-022-14314-2 [Google Scholar] [Crossref]

75. Olubodun, T., Olaniran, A., Awowole, I. O., & Ohazurike, E. (2025). Practice of opportunistic cervical cancer screening and health education among health workers in Ogun State, Nigeria: A qualitative study of barriers and opportunities. Preprints.org. https://www.preprints.org/manuscript/202503.1287 [Google Scholar] [Crossref]

76. Olubodun, T., Olaniran, A., Awowole, I. O., Ohazurike, E., Soyannwo, T., Adebisi, O. I., Adedayo, O. O., Issa, K. O., Olorunfemi, S. O., Akinmolayan, O. O., Isarinde, O. A., Boladale, I. O., Ajewole, G. A., & Morhason-Bello, I. O. (2025). Practice of opportunistic cervical cancer screening and health education among health workers in Ogun State, Nigeria: A qualitative study of barriers and facilitators [Preprint]. Preprints.org. https://doi.org/10.20944/preprints202503.1287.v1 [Google Scholar] [Crossref]

77. Omowhara, O. B., Ameh, S. & Banjo, A. A. (2023). Cervical cancer screening awareness and uptake among under-screened women in a rural Nigerian community. The Nigerian Health Journal, 22(4), 428-432. https://doi.org/10.60787/tnhj.v22i4.629 [Google Scholar] [Crossref]

78. Onubogu, C. U., Ikpeze, O. Z., Agala, V. R., Wonodi, C., Igbolekwe, C. O., Adebiyi, O., Mana, A. U., Odimegwu, C. L., Madubueze, U. C., Okpebiri, K. O., Alatishe-Muhammad, B. W., Abdulahi, F., Okesina, B. S., Ogundele, T., Muhammad-Idris, Z. K., Maduka, O., & Ogu, R. (2025). The MWAN experience in scaling-up HPV vaccination in Nigeria: Challenges, lessons learned, and future directions. Journal of Medical Women’s Association of Nigeria, 10(1). https://doi.org/10.71526/jmwan.v10i1.72 [Google Scholar] [Crossref]

79. Onwuamah, C. K., Feng, N., Momoh, A. E., Uwandu, M., Ahmed, R. A., Idigbe, I., Vincent, G. D., Ogbu, C. A., Okonkwo, N., Sokei, J., Abimbola, B. S., Ojopagogo, T., Okoli, L. C., Adesina, M., Ezemelue, P. N., Sowunmi, O., Okwuzu, J., Labo−Popoola, O. H., Shaibu, J. O., Ohihoin, G. A., Nzeribe, E., David, A., Olaleye, O., Ofotokun, I., Dong, X., & Ezechi, O. C. (2023). Prevalence and risk factors for high-risk human papillomavirus infection among women from three southern geopolitical zones of Nigeria. Frontiers in Oncology, 13, 1254304. https://doi.org/10.3389/fonc.2023.1254304 [Google Scholar] [Crossref]

80. Osuchukwu, E. C., Okpuruka, P. O. U., Ezekiel, R., & Standley, I. B. (2025). Factors influencing the uptake of human papillomavirus vaccine among female undergraduate students at the University of Calabar, Cross River State, Nigeria. Global Journal of Pure and Applied Sciences, 31(3). https://doi.org/10.4314/gjpas.v31i3.6 [Google Scholar] [Crossref]

81. Owolabi, G. O., & Jegede, A. S. (2024). Socio-cultural determinants of uptake of cervical cancer screening among women in Oyo State, Nigeria. Ibadan Journal of Sociology, 15(2). https://www.ibadanjournalofsociology.org.ng [Google Scholar] [Crossref]

82. Paswan, A., Kumar, A., Jha, K., & Sinha, S. K. (2018). VIA (Visual inspection with acetic acid) and VILI (Visual inspection with Lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(1). https://doi.org/10.18203/2320-1770.ijrcog20175847 [Google Scholar] [Crossref]

83. Perkins, R. B., Guido, R. S., Castle, P. E., Chelmow, D., Einstein, M. H., Garcia, F., ... & SGO Education Committee. (2020). ASCCP recommendations for extending cervical cancer screening intervals. Obstetrics & Gynecology, 135(1), 20-27. https://doi.org/10.1097/AOG.0000000000003595 [Google Scholar] [Crossref]

84. Petersen, Z., Jaca, A., Ginindza, T. G., Maseko, G., Takatshana, S., Ndlovu, P., Zondi, N., Zungu, N., Varghese, C., Hunting, G., Parham, G., Simelela, P. & Moyo, S. (2022). Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC women's health, 22(1), 486. https://doi.org/10.1186/s12905-022-02043-y [Google Scholar] [Crossref]

85. Petersen, Z., Jaca, A., Ginindza, T. G., Maseko, G., Takatshana, S., Ndlovu, P., Zondi, N., Zungu, N., Varghese, C., Hunting, G., Parham, G., Simelela, P., & Moyo, S. (2022). Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC women's health, 22(1), 486. https://doi.org/10.1186/s12905-022-02043-y [Google Scholar] [Crossref]

86. Ritchie, H & Roser, M. (2024). Gender Ratio: How does the number of men and women differ between countries? And why? Our World in Data. https://ourworldindata.org/gender-ratio [Google Scholar] [Crossref]

87. Selji, Y., Adisa, J. O., Gamde, S. M., Bali, K. I., Udo, M. S., & Ikeh, C. A. (2025). Knowledge and risk factors of intraepithelial lesion amongst women of childbearing age in Jos, Nigeria. Journal of Applied Sciences and Environmental Management, 29(4), 1141–1147. https://dx.doi.org/10.4314/jasem.v29i4.16 [Google Scholar] [Crossref]

88. Sodipo, O. Y., Afolaranmi, T. O., Agbo, H. A., Zoakah, A. I., & Ogbonna, C. (2025). Effect of mobile health intervention on perception and uptake of cervical cancer screening among nurses in Jos University Teaching Hospital. Journal of Interventional Epidemiology and Public Health, 8(4). https://www.afenet-journal.net/view/content.php?item=volume [Google Scholar] [Crossref]

89. Sowemimo O. O., Ojo O. O. & Fasubaa O. B. (2017) Cervical cancer screening and practice in low resource countries: Nigeria as a case study. Trop J Obstet Gynaecol. 34(3):170-176. [Google Scholar] [Crossref]

90. Spayne, J., and Hesketh, T. (2021). Estimate of global human papillomavirus vaccination coverage: analysis of country-level indicators. BMJ open, 11(9), e052016. https://doi.org/10.1136/bmjopen-2021-052016 [Google Scholar] [Crossref]

91. Srinath, A., van Merode, F., Rao, S. V., & Pavlova, M. (2023). Barriers to cervical cancer and breast cancer screening uptake in low- and middle-income countries: a systematic review. Health policy and planning, 38(4), 509–527. https://doi.org/10.1093/heapol/czac104 [Google Scholar] [Crossref]

92. Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660 [Google Scholar] [Crossref]

93. Taflinger, S., & Sattler, S. (2024). A situational test of the health belief model: How perceived susceptibility mediates the effects of the environment on behavioral intentions. Social Science & Medicine, 346, 116715. https://doi.org/10.1016/j.socscimed.2024.116715 [Google Scholar] [Crossref]

94. Taneja, D. K., Sharma, M., & Shankar, R. (2021). Knowledge, attitude, and practices regarding cervical cancer and screening among women in India: A systematic review. Asian Pacific Journal of Cancer Prevention, 22(3), 715–723. https://doi.org/10.31557/APJCP.2021.22.3.715 [Google Scholar] [Crossref]

95. Taniguchi, C., Narisada, A., Ando, H., Hashimoto, A., Nakayama, A., Ito, M., Tanaka, H., & Suzuki, K. (2023, October 6). Smoking cessation behavior in patients with a diagnosis of a non-communicable disease: The impact of perceived disease severity of and susceptibility to the disease. Tobacco Induced Diseases, 21, 125. https://doi.org/10.18332/tid/170430 [Google Scholar] [Crossref]

96. Waller, J., Marlow, L. A. V., & Wardle, J. (2007). The impact of knowing that HPV is a sexually transmitted infection: An experimental study of emotional responses and stigma. Sexually Transmitted Infections, 83(2), 129–132. https://doi.org/10.1136/sti.2006.023036 [Google Scholar] [Crossref]

97. Wang, R., Pan, W., Jin, L., Huang, W., Li, Y., Wu, D., Gao, C., Ma, D., and Liao, S. (2020). Human papillomavirus vaccine against cervical cancer: Opportunity and challenge. Cancer letters, 471, 88–102. https://doi.org/10.1016/j.canlet.2019.11.039 [Google Scholar] [Crossref]

98. Wendler D. (2021). The Inevitability and Ethics of Inaccurate Screening in Clinical Trials: A Call for Research and Guidance. Ethics & human research, 43(4), 37–44. https://doi.org/10.1002/eahr.500098 [Google Scholar] [Crossref]

99. World Health Organisation (2015). Cervical cancer common amongst African women. https://www.afro.who.int/news/cervical-cancer-common-amongst-african-women [Google Scholar] [Crossref]

100. World Health Organisation (2023a). Nigeria to vaccinate 7.7 million girls against leading cause of cervical cancer. Retrieved from https://www.afro.who.int/countries/nigeria/news/nigeria-vaccinate-77-million-girls-against-leading-cause-cervical-cancer [Google Scholar] [Crossref]

101. World Health Organisation (2023b). Cervical cancer - Early detection saves lives. Retrieved from https://www.afro.who.int/countries/nigeria/news/cervical-cancer-early-detection-saves-lives [Google Scholar] [Crossref]

102. World Health Organisation (2024). Cervical Cancer. https://www.who.int/news-room/fact-sheets/detail/cervical-cancer [Google Scholar] [Crossref]

103. World Health Organization. (2014). Comprehensive cervical cancer control: A guide to essential practice (ISBN 978 92 4 154895 3). World Health Organization. https://www.who.int/publications/i/item/9789241548953 [Google Scholar] [Crossref]

104. World Health Organization. (2020). Global strategy to accelerate the elimination of cervical cancer as a public health problem. World Health Organization. https://www.who.int/publications/i/item/9789240014107 [Google Scholar] [Crossref]

105. World Health Organization. (2021). Global strategy to accelerate the elimination of cervical cancer as a public health problem. https://www.who.int/publications/i/item/9789240014107 [Google Scholar] [Crossref]

106. World Health Organization. (2023a). Cervical cancer elimination initiative. Retrieved July 16, 2025, from https://www.who.int/initiatives/cervical-cancer-elimination-initiative [Google Scholar] [Crossref]

107. Yang M., Du J., Lu H., Xiang F., Mei H., and Xiao H. (2022). Global trends and age-specific incidence and mortality of cervical cancer from 1990 to 2019: an international comparative study based on the Global Burden of Disease. BMJ Open; 12e055470 [Google Scholar] [Crossref]

108. Zhang, S., Xu, H., Zhang, L., & Qiao, Y. (2020). Cervical cancer: Epidemiology, risk factors and screening. Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 32(6), 720–728. https://doi.org/10.21147/j.issn.1000-9604.2020.06.05 [Google Scholar] [Crossref]

109. Zhang, X., Zeng, Q., Cai, W., and Ruan, W. (2021). Trends of cervical cancer at global, regional, and national level: data from the Global Burden of Disease study 2019. BMC public health, 21(1), 894. https://doi.org/10.1186/s12889-021-10907-5 [Google Scholar] [Crossref]

110. Zou, S., Qi, X., Marshall, K., Bhura, M., Takesue, R., & Tang, K. (2022). Understanding the context of healthcare utilisation for children under-five with diarrhoea in the DRC: Based on Andersen behavioural model. BMC Health Services Research, 22, Article 1234. https://doi.org/10.1186/s12913-022-07530-4 [Google Scholar] [Crossref]

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