Knowledge, Attitude and Practices of Cervical Cancer Screening among Female Teachers in an Urban Community in Lagos, Nigeria.
Main Article Content
Keywords
Cervical Cancer, Teachers, Knowledge, Screening
Abstract
Background: In Nigeria, inadequate regular screening services for cervical cancer, as well as poor uptake of available cervical cancer screening modalities, continue to challenge cervical cancer prevention. This study seeks to assess the knowledge, attitude and practices of cervical cancer screening among female secondary school teachers whose effective role in the communication and motivation of young students have been largely documented in the literature.
Methodology: This was a descriptive cross-sectional study conducted among 273 female teachers in the Oshodi-Isolo Local Government Area of Lagos State selected by the multi-stage sampling method. Data was collected using a self-administered questionnaire and analyzed using Epi info 7.2 statistical software. The Chi-square test was used to determine statistical associations. A p-value of <0.05 was considered statistically significant.
Results: The mean age of the respondents was 39.7 ± 8.6. Respondents were mostly married, 219(80.2%) in a monogamous family setting, and 175(64.1%). The majority, 224(80.2%), had an overall poor knowledge of cervical cancer, and only 73(26.7%) could correctly link HPV as a cause of cervical cancer. Multiple sexual partners 52(19.1%) and early sexual onset 45(16.5%) were the commonest risk factors known by respondents. Although the majority had a positive attitude of 249(91.2%) towards cervical cancer screening, the overall practice was majorly poor (246(90.1%).
Conclusion: Our result demonstrates an overwhelming majority of female teachers had poor knowledge and poor cervical cancer screening practices. This highlights the need for effectively disseminating information on cervical cancer and screening to teachers to foster the effective transmission of accurate information about cervical cancer to young students.
References
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Rural Women in Lagos, Nigeria. Journal of Community Medicine and Primary Health Care 2017; 29:81-88
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Nigerian female population. Trop J Obstet Gynae. 2005; 22:21–4.
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Edinburgh University Global Health Society http://www.jogh.org/documents/issue202001/jogh-10-010329.htm
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31. Odeyemi, IA. Community-based health insurance programmes and the national health insurance scheme of Nigeria:
challenges to uptake and integration. Int J Equity Health 2014; 13: 20
32. Assoumou SA, Mabika BM, Mbiguino AN, Mouallif M, Khattabi A, EnnajI MM. Awareness and knowledge
regarding of cervical cancer, Pap smear screening and human papillomavirus infection in Gabonese women. BMC
women's health. 2015; 15:37
33. Mengesha A, Messele A, Beletew B. Knowledge and attitude towards cervical cancer among reproductive age group
women in Gondar town, North West Ethiopia. BMC Public Health 2020; 20:209
34. Ali F, Kuelker R, Wassie B. Understanding cervical cancer in the context of developing countries. Ann Trop Med
Public Health. 2012; 5:3.
35. Mitiku I, Tefera F. Knowledge about Cervical Cancer and Associated Factors among 15–49-Year-Old Women in
Dessie Town, Northeast Ethiopia 2016; PLoS ONE 11: e0163136. https://doi.org/10.1371/journal.pone.0163136
36. Okunowo AA Daramola ES,.Soibi-Harry AP, Ezenwankwo FC, Kuku OJ, Okunade KS, Anorlu RI, Women's
knowledge of cervical cancer and uptake of Pap smear testing and the factors influencing it in a Nigerian tertiary
hospital. Journal of Cancer Research and Practice 2018; 5:105-111
37. Owoeye IOG, Ibrahim IA. Knowledge and attitude towards cervical cancer screening among female students and
staff in a tertiary institution in the Niger Delta. International Journal of Medicine and Biomedical research. 2013
January; 2:48-56
38. Yahya A, Mande A T. Awareness and knowledge of cervical cancer and its screening methods among women
attending primary healthcare centers in Zaria, North-Western, Nigeria. Trop J Obstet Gynaecol 2019; 36:271-6
39. Nwozor CM. Oragudosi AL. Awareness and uptake of cervical cancer screening among women in Onitsha, SouthWest Nigeria. Greener J Medical Sci 2013; 3:283-88.
40. Akinola OI, Aimakhu CO, Ezechi OC, Fasubaa OB. Society of Obstetrics and Gynaecology of Nigeria. Clinical
practice guidelines: Guidelines for the prevention of cervical cancer. Trop J ObstetGynaecol 2018; 35:371-376.
41. John J. The Knowledge, attitude, practice and perceived barriers towards screening for premalignant lesions among
women aged 18 years and above in Songea Urban, Ruvama Muhimbili Univ Health Allied Sci. 2011
42. Almobarak AO1, Elbadawi AA, Elmadhoun WM, Elhoweris MH, Ahmed MH. Knowledge, Attitudes and Practices
of Sudanese Women regarding pap smear test and cervical cancer. Asian Pacific Journal of Cancer Prevention. 2017;
17:625-630.
43. Turkistanli EC, Sogukpinar N, Saydam BK, Aydemir G. Cervical cancer prevention and early detection--the role of
nurses and midwives. Asian Pac J Cancer Prev 2003; 4:15-21
44. Aweke YH, Ayanto SY , Ersado TL. Knowledge, attitude and practice for cervical cancer prevention and control
among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based crosssectional study. PLOS ONE. 2017; e0181415
45. Mutambaraa J, Mutandwa P, Mahapac M,Nkiwaneb VCS, Shangahaidonhic T, Knowledge, attitudes and practices of
cervical cancer screening among women who attend traditional churches in Zimbabwe. Int J Environ Res Public
Health. 2017; 14:967
46. Ramathuba DU, Ngambi D, Khoza LB, Ramakuela NJ. Knowledge, attitudes and practices regarding cervical cancer
prevention at Thulamela Municipality of Vhembe District in Limpopo Province. African Journal of Primary Health
Care and Family Medicine. 2016; 17; 8.e1-7
47. Lott BE., Trejo MJ., Baum C, McClelland JD, Adsul P, Madhivanan P. et al. Interventions to increase uptake of
cervical screening in sub-Saharan Africa: a scoping review using the integrated behavioral model. BMC Public
Health 20, 654 (2020). https://doi.org/10.1186/s12889-020-08777-4
48. Okunowo AA, Smith-Okonu ST. Cervical cancer screening among urban Women in Lagos, Nigeria: Focus on
barriers and motivators for screening. Niger J Gen Pract 2020; 18:10-6
49. Bukar M, Takai IU, Audu BM. Determinants of utilization of Papanicolaou smear among outpatient clinic attendees
in North-Eastern Nigeria. Afr J Med Med Sci 2012; 41:183-9.
50. Bakari M, Takai IU, Bukar M. Awareness and utilization of Papanicoloau smear among health care workers in
Maiduguri, Nigeria. Niger J Basic Clin Sci 2015; 12:34-38.
51. Mutyaba T, Mmiro FA, Weiderpass E. Knowledge, attitudes and practices on cervical cancer screening among the
medical workers of Mulago hospital, Uganda. BMC Med Educ 2006; 6:13
52. Al Sairafi M, Mohamed FA. Knowledge, attitudes, and practice related to cervical cancer screening among Kuwaiti
women. Med Princ Pract 2009; 18:35-42.
53. Udigwe GO. Knowledge, attitude and practice of cervical cancer screening (pap smear) among female nurses in
Nnewi, South Eastern Nigeria. Niger J Clin Pract 2006; 9:40-3.
54. Onah HE, Ozugwu FO, Eze JM. Cervical cancer screening. A survey of current practice among Nigerian
Gynaecologist. Trop J ObstetGynaecol 2001; 18:78-81.
55. Mbamara S, Ikpeze O, Okonkwo J, Igwebuike O, Ukah C. Knowledge, Attitude and Practice of Cervical Cancer
Screening Among Women Attending Gynecology Clinics in a Tertiary Level Medical Care Center in Southeastern
Nigeria. The Journal of reproductive medicine. 2011; 56:491-6.
56. Wong LP, Wong LY, Low WY, Khoo EM, Shuib R. Knowledge and awareness of cervical cancer and screening
among Malaysian women who have never had a pap smear: A qualitative study. Singapore Med J 2009; 50:49-53.
https://www.cdc.gov/cancer/cervical/ [Accessed 2017 May 28].
2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN
estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians
2018; 68: 394–424
3. Human Papillomavirus and Related Cancers, Fact Sheet 2017. Available from:
www.hpvcentre.net/statistics/reports/NGA_FS.pdf [Accessed 2017 May 29]
4. Lynette D, Rose A. Cervical Cancer in Africa. Cancer Epidemiol Biomarkers Prev 2012; 21:1434-1438
5. National Cervical Cancer Coalition. Cervical Cancer Overview. Available from: http://www.nccconline.org/hpvcervical-cancer/cervical-cancer-overview/[Accessed 2020 May 29]
6. Aina JK, Olanipekun SS, Garuba IA. 'Teacher's Effectiveness and its Influence on Student's Learning. Advances in
Social Sciences Research Journal 2015; 2:88B95.
7. James S, Thomas W, Leslie G. What Makes Good Teachers Good? A Cross-Case Analysis of the Connection
Between Teacher Effectiveness and Student Achievement. Journal of Teacher Education. 2011; 62:339-355.
8. Obodo GC. Teacher Effectiveness as an Indicator of Quality Education. APGEN Mnonograph Series, 1990; 1,
Owerri: Totan Publishers Ltd.
9. Aina, JK Effective Teaching and Learning in Science Education through information and Communication
Technology [ICT]. IOSR Journal of Research and Method in Education 2013; 2;43-47.
10. Okunade SK, Nwogu CM, Oluwole AA, Anorlu RI. Prevalence and risk factors for genital high-risk human
papillomavirus infection among women attending the out-patient clinics of a university teaching hospital in Lagos,
Nigeria. Pan African Medical Journal. 2017; 28:227
11. Fentie, AM, Tadesse TB, Gebretekle, GB. Factors affecting cervical cancer screening uptake, visual inspection with
acetic acid positivity and its predictors among women attending cervical cancer screening service in Addis Ababa,
Ethiopia. BMC Women's Health 2020; 20:147.
12. McClung NM, Gargano JW, Bennett NM, Niccolai LM, Abdullah N,Griffin MR, et al.. Trends in human
papillomavirus vaccine types 16 and 18 in cervical precancers, 2008–2014,” Cancer Epidemiol Biomarkers Prev
2019; 28:602–609
13. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012,” CA: A Cancer
Journal for Clinicians 2015; 65:87–108
14. Torre LA, Islami F, Siege RL, Ward EM, Jemal A. Global cancer in women: burden and trends. Cancer
Epidemiology Biomarkers & Prevention 2017; 26: 444–457
15. Franco EL. Persistent HPV infection and cervical cancer risk: is the scientific rationale for changing the screening
paradigm enough? JNCI J Natl Cancer Inst. 2010; 102:1451–1453.
16. Audu BM, EL-Nafaty AU, Khalil M, Otubu JA. Knowledge and attitude to cervical cancer screening among women
in Maiduguri, Nigeria. J Obstet Gynacol. 1999; 19:295–297
17. Ifemelumma CC, Anikwe CC, Okorochukwu BC, Onu FA, Obuna JA, Ejikeme BN, et al. Cervical Cancer Screening:
Assessment of Perception and Utilization of Services among Health Workers in Low Resource Setting", International
Journal of Reproductive Medicine 2019; Article ID 6505482.
18. Sachan PL, Singh M, Patel ML, Sachan R. A Study on Cervical Cancer Screening Using Pap Smear Test and Clinical
Correlation. Asia Pac J Oncol Nurs. 2018; 5:337-341.
19. Devarapalli P, Satyanarayana L, Nagarjuna N, Panchal P, Asthana S. Barriers affecting uptake of cervical cancer
screening in low- and middle-income countries: A systematic review 2019; Indian Journal of Cancer 55:318
20. Ahmed SA, Sabit K, Idris SH, Ahmed R. Knowledge, attitude and practice of cervical cancer screening among
market women in Zaria, Nigeria. Niger Med J. 2013; 54: 316–319
21. Centers for Disease Control and Prevention: Cancer Prevention and Control; 2016 Available from:
https://www.cdc.gov/cancer/dcpc/prevention/index.htm. [Accessed 2017 May 29]
22. Nnadi DC, Nwobodo EI, Ekele BA, Sahabi SM. Screening for Cervical Cancer: A Review of Outcome among
Infertile Women in a Tertiary Hospital in North-West Nigeria. Ann Med Health Sci Res. 2014; 4: 383–387
23. Idowu A, Olowookere SA, Fagbemi TA, Ogunlaja OA. Determinants of Cervical Cancer Screening Uptake among
Women in Ilorin, North Central Nigeria: A Community-Based Study. J. Cancer Epidemiol. 2016; 2016: 6469240
24. Aisha Mukhtar Dodo, Sociocultural barriers to breast and cervical cancer screening in Northern Nigeria. Epid jor of
surg canc 2016; 42: s242
25. Ogu RN, Ojule JD. Overview and prevention of cervical cancer. The Nigerian Health Journal 2014; 14:143-149
26. Abiodun OA, Fatungase OK, Olu-Abiodun OO. Knowledge, perception and predictors of uptake of cervical
screening among rural Nigerian women. Journal of Public Health and Epidemiology 2014; 6, 119-124.
27. Oluwole EO, Mohammed AS, Akinyinka MR, Salako O. Cervical Cancer Awareness and Screening Uptake among
Rural Women in Lagos, Nigeria. Journal of Community Medicine and Primary Health Care 2017; 29:81-88
28. Trasias M, Rawlance N, Angele M, Abdullah AH, David Musoke. Women's knowledge and attitudes towards
cervical cancer prevention: a cross sectional study in Eastern Uganda. BMC Women's Health. 2017; 17:9.
29. Ayinde OA, Ogunbode OO. Determinants of cervical cancer knowledge and its utilization of screening among a
Nigerian female population. Trop J Obstet Gynae. 2005; 22:21–4.
30. Onosanya AA. Increasing Health Insurance in the Informal Sector. Journal of Global Health (ISSN 2047-2986),
Edinburgh University Global Health Society http://www.jogh.org/documents/issue202001/jogh-10-010329.htm
[Accessed 2017 May 29]
31. Odeyemi, IA. Community-based health insurance programmes and the national health insurance scheme of Nigeria:
challenges to uptake and integration. Int J Equity Health 2014; 13: 20
32. Assoumou SA, Mabika BM, Mbiguino AN, Mouallif M, Khattabi A, EnnajI MM. Awareness and knowledge
regarding of cervical cancer, Pap smear screening and human papillomavirus infection in Gabonese women. BMC
women's health. 2015; 15:37
33. Mengesha A, Messele A, Beletew B. Knowledge and attitude towards cervical cancer among reproductive age group
women in Gondar town, North West Ethiopia. BMC Public Health 2020; 20:209
34. Ali F, Kuelker R, Wassie B. Understanding cervical cancer in the context of developing countries. Ann Trop Med
Public Health. 2012; 5:3.
35. Mitiku I, Tefera F. Knowledge about Cervical Cancer and Associated Factors among 15–49-Year-Old Women in
Dessie Town, Northeast Ethiopia 2016; PLoS ONE 11: e0163136. https://doi.org/10.1371/journal.pone.0163136
36. Okunowo AA Daramola ES,.Soibi-Harry AP, Ezenwankwo FC, Kuku OJ, Okunade KS, Anorlu RI, Women's
knowledge of cervical cancer and uptake of Pap smear testing and the factors influencing it in a Nigerian tertiary
hospital. Journal of Cancer Research and Practice 2018; 5:105-111
37. Owoeye IOG, Ibrahim IA. Knowledge and attitude towards cervical cancer screening among female students and
staff in a tertiary institution in the Niger Delta. International Journal of Medicine and Biomedical research. 2013
January; 2:48-56
38. Yahya A, Mande A T. Awareness and knowledge of cervical cancer and its screening methods among women
attending primary healthcare centers in Zaria, North-Western, Nigeria. Trop J Obstet Gynaecol 2019; 36:271-6
39. Nwozor CM. Oragudosi AL. Awareness and uptake of cervical cancer screening among women in Onitsha, SouthWest Nigeria. Greener J Medical Sci 2013; 3:283-88.
40. Akinola OI, Aimakhu CO, Ezechi OC, Fasubaa OB. Society of Obstetrics and Gynaecology of Nigeria. Clinical
practice guidelines: Guidelines for the prevention of cervical cancer. Trop J ObstetGynaecol 2018; 35:371-376.
41. John J. The Knowledge, attitude, practice and perceived barriers towards screening for premalignant lesions among
women aged 18 years and above in Songea Urban, Ruvama Muhimbili Univ Health Allied Sci. 2011
42. Almobarak AO1, Elbadawi AA, Elmadhoun WM, Elhoweris MH, Ahmed MH. Knowledge, Attitudes and Practices
of Sudanese Women regarding pap smear test and cervical cancer. Asian Pacific Journal of Cancer Prevention. 2017;
17:625-630.
43. Turkistanli EC, Sogukpinar N, Saydam BK, Aydemir G. Cervical cancer prevention and early detection--the role of
nurses and midwives. Asian Pac J Cancer Prev 2003; 4:15-21
44. Aweke YH, Ayanto SY , Ersado TL. Knowledge, attitude and practice for cervical cancer prevention and control
among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based crosssectional study. PLOS ONE. 2017; e0181415
45. Mutambaraa J, Mutandwa P, Mahapac M,Nkiwaneb VCS, Shangahaidonhic T, Knowledge, attitudes and practices of
cervical cancer screening among women who attend traditional churches in Zimbabwe. Int J Environ Res Public
Health. 2017; 14:967
46. Ramathuba DU, Ngambi D, Khoza LB, Ramakuela NJ. Knowledge, attitudes and practices regarding cervical cancer
prevention at Thulamela Municipality of Vhembe District in Limpopo Province. African Journal of Primary Health
Care and Family Medicine. 2016; 17; 8.e1-7
47. Lott BE., Trejo MJ., Baum C, McClelland JD, Adsul P, Madhivanan P. et al. Interventions to increase uptake of
cervical screening in sub-Saharan Africa: a scoping review using the integrated behavioral model. BMC Public
Health 20, 654 (2020). https://doi.org/10.1186/s12889-020-08777-4
48. Okunowo AA, Smith-Okonu ST. Cervical cancer screening among urban Women in Lagos, Nigeria: Focus on
barriers and motivators for screening. Niger J Gen Pract 2020; 18:10-6
49. Bukar M, Takai IU, Audu BM. Determinants of utilization of Papanicolaou smear among outpatient clinic attendees
in North-Eastern Nigeria. Afr J Med Med Sci 2012; 41:183-9.
50. Bakari M, Takai IU, Bukar M. Awareness and utilization of Papanicoloau smear among health care workers in
Maiduguri, Nigeria. Niger J Basic Clin Sci 2015; 12:34-38.
51. Mutyaba T, Mmiro FA, Weiderpass E. Knowledge, attitudes and practices on cervical cancer screening among the
medical workers of Mulago hospital, Uganda. BMC Med Educ 2006; 6:13
52. Al Sairafi M, Mohamed FA. Knowledge, attitudes, and practice related to cervical cancer screening among Kuwaiti
women. Med Princ Pract 2009; 18:35-42.
53. Udigwe GO. Knowledge, attitude and practice of cervical cancer screening (pap smear) among female nurses in
Nnewi, South Eastern Nigeria. Niger J Clin Pract 2006; 9:40-3.
54. Onah HE, Ozugwu FO, Eze JM. Cervical cancer screening. A survey of current practice among Nigerian
Gynaecologist. Trop J ObstetGynaecol 2001; 18:78-81.
55. Mbamara S, Ikpeze O, Okonkwo J, Igwebuike O, Ukah C. Knowledge, Attitude and Practice of Cervical Cancer
Screening Among Women Attending Gynecology Clinics in a Tertiary Level Medical Care Center in Southeastern
Nigeria. The Journal of reproductive medicine. 2011; 56:491-6.
56. Wong LP, Wong LY, Low WY, Khoo EM, Shuib R. Knowledge and awareness of cervical cancer and screening
among Malaysian women who have never had a pap smear: A qualitative study. Singapore Med J 2009; 50:49-53.
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Sep 12, 2022
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How to Cite
Surakatu, O. K., Onyeodi, I. . A., & Balogun, M. R. (2022). Knowledge, Attitude and Practices of Cervical Cancer Screening among Female Teachers in an Urban Community in Lagos, Nigeria . Nigerian Medical Journal, 63(3), 236–247. https://doi.org/10.60787/nmj.v63i3.112
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