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Utilization of opportunistic cervical cancer screening in Nigeria

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Abstract

Background

While various interventions have been conducted to decrease cervical cancer’s burden in Nigeria, no study has examined the trends in cervical cancer screening uptake over time. The present study sought to fill this gap in knowledge using data collected at Jos University Teaching Hospital (JUTH) in Nigeria.

Methods

Data collected continuously between 2006 and 2016 were analyzed to identify trends in screening uptake, changes in risk factors for cervical cancer, and to identify factors for women screened at Jos University Teaching Hospital (JUTH) in Jos, Nigeria. Categorical analyses and logistic regression models were used to describe patient characteristics by year, and to identify factors associated with repeated screening uptake.

Results

A total of 14,088 women who were screened between 2006 and 2016 were included in the database; 2,800 women had more than one screening visit. Overall, screening uptake differed significantly by year. On average women were first screened at age 38. About 2% of women screened were women living with HIV. Most women (86%) had normal pap smear at first screening, with the greatest decreased risk of abnormalities observed between 2011 and 2014. Odds of a follow-up screening after a normal result decreased significantly between 2008 and 2016 compared to women screened in 2006 and 2007. Finally, women living with HIV had increased odds of follow-up screening after having a normal pap smear.

Conclusions

These findings contribute to our understanding of the potential social and health system barriers to cervical cancer control in Nigeria. The findings may assist policy makers to design interventions to increase access and compliance to recommended screening schedules in this vulnerable population.

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Data availability

The datasets for this study belong to the Operation Stop Cervical Cancer Unit of the Jos University Teaching Hospital (JUTH) and could be made available on reasonable request to corresponding author.

Abbreviations

JUTH:

Jos University Teaching Hospital

HIV:

Human Immunodeficiency Virus

LMICs:

Low-and-middle-income counties

OSCC:

Operation Stop Cervical Cancer

AORTIC:

African Organization for Research and Training in Cancer

AS-CUS:

Atypical Squamous Cells of Undetermined Significance

LSIL:

Low-grade Squamous Intraepithelial Lesion

ASC-H:

Atypical Squamous Cells, cannot exclude High-grade Lesion

AGUS:

Atypical Glandular Cells

HSIL:

High-grade Squamous Intraepithelial Lesion

STI:

Sexually transmitted infection

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Acknowledgments

Not applicable.

Funding

Research reported in this publication was supported by the Global Health Equity Scholars NIH FIC under Award Number 3D43TW010540-05-S3. JM receives funding support through the NIH/FIC, K43TW011416 for career development and research protected time for review and writing of this manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Fogarty International Center nor the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA

    Magdiel A. Habila & Elizabeth T. Jacobs

  2. Department of Health and Pharmaceutical Outcomes, R. Ken Coit College of Pharmacy, University of Arizona, Tucson, AZ, USA

    Magdiel A. Habila & Mavis Obeng-Kusi

  3. Department of Obstetrics and Gynecology, University of Jos and Jos University Teaching Hospital, Jos, Plateau State, Nigeria

    Emmanuel Sagay, Maryam J. Ali, Francis A. Magaji, Iornum H. Shambe, Patrick H. Daru, Atiene S. Sagay & Jonah Musa

  4. Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA

    Purnima Madhivanan

  5. Public Health Research Institute of India, Mysore, India

    Purnima Madhivanan

  6. Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Jonah Musa

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  1. Magdiel A. Habila
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Contributions

MAH, ES, and MO-K contributed to creating the database for the analyses, analyses, and writing the manuscript. MJA, FAM, IHS, PHD, and ETJ contributed to the acquisition of data, contextualization, interpretation of the analyses, and writing of this manuscript. PM, ASS, and JM contributed to the conceptualization of the research question, acquisition of funding, and writing of this manuscript.

Corresponding author

Correspondence to Magdiel A. Habila.

Ethics declarations

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

This project was reviewed and approved by the Institutional Review Board Human Subjects Protection Program at the University of Arizona (Protocol Number: 2108135158) and by the Institutional Review Board at Jos University (Reference: JUTH/DCS/IREC/127/XXI/2575). All methods described were performed in accordance with the Declaration of Helsinki and with the relevant guidelines and regulations outlined by the Human Subjects Protection Program at the University of Arizona and by the IRB at Jos University.

Consent to participate

The IRB at the University of Arizona waived the need to obtain informed consent from participants since these analyses were conducted using de-identified data.

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Habila, M.A., Sagay, E., Obeng-Kusi, M. et al. Utilization of opportunistic cervical cancer screening in Nigeria. Cancer Causes Control 35, 9–20 (2024). https://doi.org/10.1007/s10552-023-01764-1

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