KNOWLEDGE AND ACCEPTANCE OF CERVICAL CANCER SCREENING AMONG WOMEN OF CHILD BEARING AGE IN GADAM COMMUNITY KWAMI LOCAL GOVERNMENT GOMBE STATE

CHAPTER 1: INTRODUCTION
1.1 Background of the Study
Cervical cancer remains a significant public health concern, particularly in low- and middle-income countries where access to screening and preventive measures is limited (WHO, 2022). It is the fourth most common cancer among women globally, with approximately 90% of cervical cancer-related deaths occurring in developing nations (Ferlay et al., 2021). In Nigeria, cervical cancer is the second most frequent cancer among women, with an estimated 14,089 new cases and 8,240 deaths annually (IARC, 2023). Despite the availability of screening methods such as the Pap smear, Visual Inspection with Acetic Acid (VIA), and HPV testing, uptake remains low due to factors like lack of awareness, cultural beliefs, and limited healthcare access (Oluwole et al., 2020).
In Gadam community, Kwami Local Government Area (LGA) of Gombe State, women of childbearing age (15-49 years) are particularly vulnerable due to inadequate health education and poor healthcare infrastructure. Understanding their knowledge and acceptance of cervical cancer screening is crucial for designing effective interventions to improve early detection and reduce mortality rates.
Cervical cancer remains a significant public health challenge globally, particularly in low- and middle-income countries (LMICs) where it accounts for a disproportionately high number of cases and deaths. Nigeria, as the most populous nation in Africa, bears a substantial burden of this preventable disease. Current estimates indicate that over 12,000 Nigerian women are diagnosed with cervical cancer annually, and nearly 8,000 die from it, making it the second most frequent cancer among women aged 15-44 years. This high mortality rate is largely attributed to late presentation of cases, often due to low awareness, inadequate screening programs, and limited access to healthcare services.
The primary cause of cervical cancer is persistent infection with high-risk types of Human Papillomavirus (HPV). Despite the availability of effective prevention strategies, including HPV vaccination and cervical cancer screening (such as Pap tests and HPV DNA testing), the uptake of these services remains remarkably low in Nigeria. National data suggests that only about 14% of Nigerian women have ever been screened for cervical cancer, with even lower rates reported in rural areas.
Several factors contribute to this low uptake. Research consistently points to a critical lack of knowledge about cervical cancer, its causes, symptoms, and the benefits of early detection through screening. Many women in rural settings are unaware that cervical cancer is preventable and treatable, leading to a fatalistic perception of the disease. Beyond knowledge gaps, significant barriers to screening include financial constraints, geographical inaccessibility to healthcare facilities, fear of the screening procedure or a positive diagnosis, cultural beliefs, social stigma surrounding reproductive health, and a lack of support from male partners.
Gombe State, located in North-East Nigeria, is predominantly rural and shares many of the healthcare challenges faced by other underserved regions in the country. While there have been efforts by the Gombe State government and international partners (such as UNICEF and WHO) to improve primary healthcare services, particularly in maternal and child health, the specific challenges related to cervical cancer screening in remote communities like Gadam remain largely underexplored. Gadam community, a ward within Kwami Local Government Area of Gombe State, represents a typical rural setting where access to specialized health services might be limited and traditional beliefs could heavily influence health-seeking behaviors.
Understanding the specific knowledge levels and acceptance patterns of cervical cancer screening among women of childbearing age in Gadam community is crucial for designing targeted and effective interventions. This study aims to bridge this knowledge gap by providing a localized perspective on the current situation, thereby informing culturally sensitive strategies to improve cervical cancer prevention and control efforts in similar contexts within Gombe State and beyond.
1.2 Statement of the Problem
Despite the high burden of cervical cancer in Nigeria, screening rates remain alarmingly low, especially in rural communities like Gadam. Many women in this region lack awareness of cervical cancer, its risk factors, and the importance of early detection (Abdulkareem, 2019). Additionally, socio-cultural barriers, fear of stigmatization, and misconceptions about screening procedures further hinder acceptance (Eze et al., 2021). The absence of structured cervical cancer prevention programs in Kwami LGA exacerbates the problem, leading to late-stage diagnoses and poor survival rates.
This study seeks to investigate the level of knowledge and acceptance of cervical cancer screening among women of childbearing age in Gadam community, identifying gaps that need to be addressed through targeted health interventions.


1.3 Aim and Objectives
The aim of this study is to assess the knowledge and acceptance of cervical cancer screening among women of childbearing age in Gadam community, Kwami LGA, Gombe State.
The specific objectives include:
1. To determine the level of awareness about cervical cancer and its screening methods among women in Gadam community.
2. To assess the acceptance rate of cervical cancer screening among women of childbearing age.
3. To identify barriers preventing women from participating in cervical cancer screening.
4. To recommend strategies for improving awareness and uptake of cervical cancer screening in the community.
1.4 Research Questions
1. What is the level of knowledge about cervical cancer and its screening methods among women of childbearing age in Gadam community?
2. To what extent do women in Gadam community accept cervical cancer screening?
3. What are the major barriers hindering women from undergoing cervical cancer screening?
4. What strategies can be implemented to improve awareness and acceptance of cervical cancer screening in the community?
1.5 Significance of the Study
This study is significant because:
• It provides insights into the knowledge gaps and attitudes toward cervical cancer screening in Gadam community, which can guide policymakers and healthcare providers in designing targeted interventions.
• Findings may contribute to reducing cervical cancer-related morbidity and mortality by promoting early detection.
• The study can serve as a reference for future research on cervical cancer prevention in rural Nigerian communities.
• It empowers women with life-saving health information, fostering better healthcare-seeking behavior.
1.6 Scope and Limitations
Scope
This study focuses on women of childbearing age (15-49 years) in Gadam community, Kwami LGA, Gombe State. It examines their knowledge, perceptions, and acceptance of cervical cancer screening.
Limitations
• The study may be limited by self-reported data, which could be subject to recall bias.
• Cultural sensitivities may affect respondents' willingness to disclose information.
• The findings may not be generalizable to other regions due to socio-cultural differences.

1.7 Definition of Key Terms
• Cervical Cancer: A malignant tumor of the cervix, primarily caused by persistent infection with high-risk human papillomavirus (HPV) strains.
• Screening: The process of testing asymptomatic individuals to detect early signs of disease.
• Knowledge: Awareness and understanding of cervical cancer, its risk factors, and screening methods.
• Acceptance: Willingness to undergo cervical cancer screening.
• Women of Childbearing Age: Females between 15 and 49 years who are biologically capable of reproduction.
References
• Abdulkareem, F. (2019). Cervical Cancer Awareness and Screening Uptake in Rural Nigeria. Journal of Public Health in Africa.
• Eze, J. N., et al. (2021). Barriers to Cervical Cancer Screening among Women in Northern Nigeria. BMC Women's Health.
• Ferlay, J., et al. (2021). Global Cancer Observatory: Nigeria. International Agency for Research on Cancer (IARC).
• Oluwole, E. O., et al. (2020). Cervical Cancer Prevention in Low-Resource Settings. Journal of Global Oncology.
• World Health Organization (WHO). (2022). Cervical Cancer Elimination Initiative.
 
CHAPTER 2: LITERATURE REVIEW
2.1 Theoretical Framework
This study is anchored on two key theoretical frameworks that help explain health-seeking behavior and the adoption of preventive health measures:
2.1.1 Health Belief Model (HBM)
The Health Belief Model (HBM) (Rosenstock, 1974) is a psychological framework that explains and predicts health-related behaviors based on individuals' perceptions. The model suggests that a person's willingness to engage in health-promoting actions (such as cervical cancer screening) depends on:
• Perceived susceptibility – Belief in the likelihood of developing cervical cancer.
• Perceived severity – Understanding the serious consequences of untreated cervical cancer.
• Perceived benefits – Belief that screening can detect cancer early and improve survival.
• Perceived barriers – Obstacles such as fear, cost, or cultural stigma that may prevent screening.
• Cues to action – Triggers such as health education or doctor’s advice that encourage screening.

    Date: 2026-08-02 00:00:00.000000