Cervical Cancer Screening Utilization and Its Correlates Among Women of Reproductive Age in North Central Nigeria: A Cross-Sectional Study

Abstract

Introduction: Cervical cancer remains a significant public health challenge in Nigeria despite the availability of screening methods. This study investigated the utilization of cervical cancer screening and associated factors among women of reproductive age attending Federal Medical Center (FMC), Keffi. Methodology: A cross-sectional study was conducted among women aged 15-49 years using a systematic random sampling method. Of 400 eligible women approached, 384 completed the questionnaire (response rate: 96.0%). Data were collected with structured questionnaires and analyzed using SPSS v26. Chi-square tests and logistic regression were used to examine associations at p ≤ 0.05. Results: Only 24% of participants had ever undergone cervical cancer screening, while 76% had never been screened. Among those screened, 65.2% utilized government facilities, and 34.8% used private hospitals. Major barriers to screening included Cost (34.2%), Lack of Awareness (30.2%), not knowing where to access services (15.1%), and the belief that screening is unnecessary without symptoms (15.1%). Multivariable logistic regression confirmed Age (aOR = 0.08; 95% CI: 0.01-0.65; p = 0.018), Marital Status (aOR = 0.09; 95% CI: 0.02-0.43; p = 0.002), Educational Status (aOR = 3.43; 95% CI: 1.34-8.76; p = 0.010), Occupation (aOR = 0.29; 95% CI: 0.11 – 0.79; p = 0.016), and Ethnicity (aOR = 0.32; 95% CI: 0.13 – 0.77; p = 0.011) as independent predictors. Conclusions: The uptake of cervical cancer screening services among women at FMC Keffi is low. Cost, poor awareness, limited knowledge of service locations, and misconceptions were key barriers. Marital status, education, occupation, and ethnicity predicted screening uptake. Reducing costs and improving targeted health education may increase utilization.