Abstract / Summary
Abstract Background Cervical cancer remains a leading cause of cancer-related morbidity and mortality among women in sub-Saharan Africa, with Nigeria bearing a disproportionately high burden. Despite the availability of cost-effective screening methods, uptake remains alarmingly low, particularly in semi-urban and rural communities where health literacy is limited and socio-cultural barriers are pronounced. Aim This study assessed knowledge, awareness, perception, and attitude as determinants of uptake and compliance with cervical cancer screening among women of reproductive age attending a clinical health care facility in Lafiagi, Edu Local Government Area, Kwara State, Nigeria. Methods A descriptive cross-sectional study was conducted among 300 women of reproductive age (15–49 years) attending General Hospital, Lafiagi, selected using a multistage sampling technique. Data were collected with a structured, interviewer-administered questionnaire covering socio-demographic characteristics, knowledge, awareness, perception, attitude, and screening uptake, and were analyzed using descriptive statistics and the chi-square test, with significance set at p < 0.05. Results Most respondents were aged 15–24 years (33.7%), married (83.3%), had only primary education (50.0%), and were traders (36.3%). Knowledge of cervical cancer was poor: only 30.0% had heard of the disease, 16.7% knew it affects the cervix, and 10.0% identified human papillomavirus (HPV) as a major cause. Awareness of screening services was low (26.7%). Negative perceptions were common − 55.0% believed screening is painful, 50.0% considered it unnecessary for healthy women, and 43.3% perceived stigma. Despite these barriers, 83.7% of respondents were willing to be screened if recommended by a health worker. Screening uptake was exceptionally low (20.3%), with fear (52.3%) and lack of awareness (41.8%) the most frequently cited barriers. Knowledge was significantly associated with uptake (χ² = 42.16, df = 1, p = 0.001), and perception was significantly associated with compliance (χ² = 24.38, df = 1, p = 0.003). Conclusion Knowledge, awareness, and uptake of cervical cancer screening in Lafiagi are critically low, and perceptions are predominantly negative, yet attitudes are positive, indicating that women are receptive to screening when properly informed. Recommendations : Health education should be intensified, health workers should routinely recommend screening during clinical encounters, and policymakers should prioritize resources for screening services, provider training, and sustained community sensitisation. Graphical Abstract