Awareness and Beliefs About Cervical Cancer, the HPV Vaccine, and Cervical Cancer Screening Among Ghanaian Women with Diverse Education Levels

  • Michelle S. Williams
  • Ernest Kenu
  • Augustine Adanu
  • Ruth Angela Yalley
  • Nicholas Kwaku Lawoe
  • Akpanga Seyram Dotse
  • Rita Fosuah Adu
  • Kevin Fontaine


Cervical cancer is the leading cause of cancer death among women in Ghana. Cost-effective tools for the primary and secondary prevention of cervical cancer, such as the Pap test, the HPV DNA test, and the HPV vaccine, are available in hospitals and clinics throughout Ghana. However, participation in cervical cancer prevention behaviors is low among Ghanaian women. Our objective was to determine if there were significant differences in cervical cancer awareness and stigmatizing beliefs about women with cervical cancer between Ghanaian women of different education levels. We surveyed 288 Ghanaian women who were at least 18 years old. Data on the participants’ demographic characteristics, awareness of cervical cancer, cervical cancer screening, and the HPV vaccine, beliefs about cervical cancer screening, and stigmatizing beliefs about women with cervical cancer was collected. Chi-square tests for independence and Fisher’s exact test of independence were preformed to determine if education level was associated with those factors. Participation in cervical cancer screening and uptake of the HPV vaccine was significantly lower among women with less than a senior high school education. Awareness about cervical cancer, cervical cancer screening, and the HPV vaccine was lower among women with less education. Women with lower levels of education were more likely to agree with the negative statements about cervical cancer screening and stigmatizing beliefs about women with cervical cancer. Cervical cancer education interventions that are tailored for Ghanaian women with different educational levels are needed to increase awareness of and participation in cervical cancer prevention strategies.


Cervical cancer prevention Ghana Women’s Health 



Special thanks to the women who participated in this study. Sincere appreciation goes to Dorothy Kelly for supporting this study. Thank you to Chee Paul Linn for his assistance with the data analysis and Drs. Bettina Beech and Derek Griffith for their review of the manuscript. This project was supported by a Career Enhancement Award from the University of Alabama at Birmingham Office of Postdoctoral Education. The content is solely the responsibility of the authors and does not necessarily represent the official views of the author’s institutions.

Compliance with Ethical Standards

Approval to conduct this study was provided by the Institutional Review Boards at the University of Alabama at Birmingham (UAB) in Birmingham (X150218005), and the Noguchi Memorial Institute for Medical Research in Accra (077/14-15). The scientific protocol was approved by the UAB Comprehensive Cancer Center Protocol Review Committee.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© American Association for Cancer Education 2018

Authors and Affiliations

  1. 1.University of Mississippi Medical CenterJacksonUSA
  2. 2.University of GhanaAccraGhana
  3. 3.Korle Bu Teaching HospitalAccraGhana
  4. 4.University of Alabama at BirminghamBirminghamUSA

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