Knowledge and Uptake of Cervical Cancer Screening among Women Attending Selected Churches in Umuahia South LGA, Abia State, Nigeria

Abstract

Background: Cervical cancer remains a leading cause of cancer-related mortality among women in Nigeria, despite the availability of effective screening. While broader studies in Nigeria have identified general barriers and facilitators, there is limited evidence on actual screening uptake, level of awareness, and the unique socio-cultural and religious factors influencing these behaviours within church communities. Aim: This study assessed the knowledge and uptake of cervical cancer screening and identified influencing factors among women attending selected churches in Umuahia South LGA, Abia State, Nigeria. Methods: A descriptive cross-sectional design was employed. A sample of 289 women aged 18-49 years was selected from five churches using a multi-stage sampling technique. Data were collected using a structured, self-administered questionnaire. Analysis involved descriptive statistics (frequencies, percentages) and inferential statistics (Chi-square tests) using SPSS version 25. Results: Majority were within the age range of 30-34 years, had secondary education (43.6%) and were married (69.9%). While 68.5% had heard of screening, comprehensive knowledge was poor: only 50.5% knew it could be asymptomatic, and 59.5% identified HPV as the cause. Overall, 56.7% had fair knowledge. Screening uptake was critically low at 29.8%. The predominant barriers were lack of detailed knowledge (21.5%), fear of diagnosis/procedure (30.5%), and high cost (11.3%). Key facilitators were a doctor’s recommendation (19.5%), free/low-cost tests (17.6%), and church-based strategies like on-site testing (14.3%) and pastoral encouragement (11.4%). Screening uptake showed no significant association with socio-demographics or knowledge level (p>0.05) but was absolutely dependent on basic awareness (χ²=56.27, p<0.001). Conclusion and Recommendation: A wide awareness-action gap exists, driven by persistent fears, cost, and insufficient knowledge, not by socio-demographics. The church is a dominant information source and a highly acceptable platform for intervention. Concerted efforts integrating targeted church-based education, affordable services, and healthcare provider advocacy are urgently recommended to transform awareness into life-saving screening behaviour.