Targeting women with free cervical cancer screening: challenges and lessons learnt from Osun state, southwest Nigeria

Abstract

IntroductionThe study was conducted to determine the challenges and suggest solutions to conducting free cervical cancer screening among Nigerian women.MethodsAwareness was created among women groups and mass media in Osun State for women to undergo free cervical cancer screening programme. Consenting women had their socio-demographic characteristics, awareness and uptake of HPV vaccine documented and papanicolaou smear procedure done with adequate referral for treatment given where necessary.ResultsA total of 287 women had cervical cancer screening. Mean (SD) age was 51.6 (14.3) years. Most participants were urban based (87.1%), married (63.1%), had secondary education (39%) and were traders (79.1%). None of the women were aware of the preventive HPV vaccine or had been vaccinated against HPV. About 6% were pre-invasive while 0.7% had invasive cervical cancer. The highest proportions of respondents affected were young, married and had lower education. Challenges identified included poor attendance, low risk perception and logistic issues.ConclusionMost participants were urban based. There is need to decentralize cancer of cervix screening through mobile clinics and establishment of screening centres in the rural areas. Neighbour to neighbour sensitization is essential. Also, HPV vaccine should be available and affordable to all girls before sexual maturity.

Implementation strategies to improve cervical cancer prevention in sub-Saharan Africa: a systematic review

“…Using clinician-collection as the reference, the sensitivity and specificity for hrHPV mRNA of tampon-collection were 77.4 and 77.8%, respectively. Good Adepoju 2016 [ 59 ] Determine sociodemographic characteristics, awareness and uptake of a free cancer screening program Nigeria Pap smear Educate: public sensitization with women groups and mass media campaign Finance: free screening Penetration: Pap smear screening coverage 287 women were screened but uptake of cervical cancer screening was low since most women did not come for the program despite the public sensitization. Poor Asgary 2016 [ 22 ] Evaluate the feasibility and efficacy of ongoing, smartphone-based support in sustaining VIA skills for community health nurses Ghana VIA, digital imaging Educate: 2-week didactic and procedural training for VIA and digital imaging, ongoing consultation Quality: audit and feedback for digital images via smartphone messaging within 24 h Fidelity: inter-rater agreement for VIA between nurses and expert physician Feasibility: VIA picture quality Agreement rate between all VIA diagnoses made by all CHNs and the expert reviewer was 95%.…”

“…Using specificity and sensitivity rates, some studies compared VIA assessments between nurses and an expert physician [ 22 , 24 , 25 , 41 ] while others compared self- vs. physician-collected samples for HPV DNA testing [ 27 , 28 , 30 , 31 , 42 , 43 ]. Sixteen studies examined if screening coverage increases when changing service sites [ 44 – 49 ], combining screening with an already established program (i.e., HIV/STI screening) [ 50 – 57 ], or providing financial incentives [ 58 , 59 ]. Four studies evaluated the effect of educational interventions on knowledge, attitudes, and screening behaviors for patients [ 60 ] and providers [ 61 – 63 ].…”

A comparative analysis of cervical cancer prevention between Nigeria and Nordic countries that have experienced a decline in cervical cancer incidence

“…Fifteen journal articles and two grey literature items were included in the review having met the selection criteria. These articles were diverse with six descriptive studies [26][27][28][29][30][31] (including one that was population-based 31 ), one randomised experimental study, 32 two population-based cluster randomised trials, 33,34 one cohort study, 10 five articles involving secondary data analyses [35][36][37][38][39] and two reports. 40,41 Six of the academic studies published in journals were set in Nigeria and nine were from the Nordic countries of interest ( Table 1).…”

Factors influencing the acceptance of cervical cancer screening among civil servants in Delta State Secretariat

“…20 Therefore, our observation of high concern over accessibility is supported; and reiterates the need for cervical service facilities to be made affordable and closer to the people. 10 Our result seems to confound affordability when viewed between stratified income levels ( Figure 2). Solely looking at the relative frequency distribution would mislead into erroneous conclusion that the women at the highest income level are doing better than those at the lowest earning cadre.…”

“…• Cervical cancer service centres need to be expounded and made closer to the people, and also made affordable. 10 • The barriers to cervical cancer screening go beyond accessibility and awareness. Socioeconomic status as well as perceptions and family support are part of psychosocial factors.…”