The need to incorporate routine cervical cancer counselling and screening in the management of women at the outpatient clinics in Nigeria

Abstract

Although cervical cancer is the commonest cause of cancer death in Nigeria, the use of cervical cancer screening is poor. This study aimed at determining the awareness and use of the available cervical cancer screening method (Pap smear) by women attending the outpatient clinics of a tertiary institution in Enugu, South-eastern Nigeria. Questionnaires were administered to 912 women from November 2005 to May 2006. A total of 550 (60.3%) respondents knew about cervical cancer but only 41.2% of them were aware of the Pap smear. Only 89 (9.0%) respondents had used the Pap smear. The majority (61.9%) of those who had not been screened despite knowledge of the Pap smear had no reason, while the remaining 112 (38.1%) felt they were not susceptible to cervical cancer. The use of the Pap smear among women attending the outpatient clinics in Enugu, Nigeria is very low. Routine cervical cancer counselling and screening with opt-out option should be offered to every eligible woman attending the outpatient clinics.

Utilization of screening services for cancer of the cervix in Makurdi, Nigeria

“…As low as 7% of the entire population studied had ever screened for the disease. Although, this rate is higher than the 2.6% and 4.2% in western and eastern Nigeria respectively [8,9]. The rate is however lower than the finding reported by Dim et al, eastern Nigeria and Hoque et al, in a rural community in South Africa [10].…”

Population-Based Prevalence of Abnormal Cervical Cytology Findings and Local Risk Factors in Ibadan, Nigeria: Implications for Cervical Cancer Control Programs and Human Papilloma Virus Immunization

“…The ideal is to target all sexually active women, but this is difficult in regions with limited resources, where knowledge of preventive screening is limited and local taboos and cultures guide health-seeking behavior. The inclusion of a cancer control program in primary or maternal health care programs might improve acceptance and willingness of women to participate in a cervical screening program [34,35]. In addition to full integration with primary/maternal health care programs, health education about risky sexual habits, genital hygiene and proper nutrition should be emphasized to improve the basic health standard of the women and the entire population.…”

Experiences and Unmet Needs of Women Undergoing Pap Smear Cervical Cancer Screening: Impact on Uptake of Cervical Cancer Screening in South Eastern Nigeria

“…Making cervical cancer screening an optional but routine investigation for women attending health care facilities in Nigeria can make significant contribution in reducing the cervical cancer burden in Nigeria. This would mean that every health worker should be made to recommend cervical cancer screening for every woman seen in the health facility, while the woman should have the option to opt out of the test [8]. This strategy is currently being used for human immunodeficiency virus (HIV) screening in antenatal clinics in Nigeria, and has recorded tremendous success.…”

“…This success story has not been replicated in many resource-constrained countries of the world, especially sub-Saharan Africa, and one of the reasons is the poor uptake of voluntary cervical cancer screening services by the female population in resource-poor countries of the world [5]. The reasons for this poor uptake include poor health-seeking behaviour of the populace, ignorance, poor education, poverty, low status of the female gender, distance, culture and religion [5][6][7][8][9]. Several evidence-based strategies have been deployed to improve uptake in resource-poor settings without much success, and these include reduction in the cost of screening and increasing the awareness of cervical cancer [10,11].…”