Gaps in Knowledge and Practice of Cervical Cancer Screening among Primary Health Care Workers in Lagos State,...

Abstract.

Cervical cancer is a major public health concern globally, particularly in low- and middle-income countries where access to screening and early diagnostic services is limited. Healthcare workers at the Primary Health Care (PHC) level play critical roles in promoting cervical cancer prevention through health education, implementing low-cost cervical cancer screening approaches in low-resource settings, and providing referral services. However, gaps in knowledge and practice among PHC workers may hinder effective cervical cancer control programs.

This study assessed knowledge, attitudes, and practices concerning cervical cancer screening among PHC workers in Lagos State, Southwest Nigeria.

A descriptive cross-sectional study was conducted among 209 PHC workers selected using multistage sampling. Data were collected using a structured questionnaire on socio-demographic characteristics, knowledge of cervical cancer, attitudes toward screening, and screening practices. Data were analysed using descriptive statistics and chi-square tests at a statistical significance level of 5%.

The respondents had a mean age of 36.8 ± 8.8 years. Most participants were female (77.0%) and married (73.7%). Nurses represented the largest professional group (41.1%), followed by community health extension workers (30.6%). Overall, 69% of respondents demonstrated good knowledge of cervical cancer screening, and 89% reported positive attitudes toward screening. However, cervical cancer screening practices were poor, as only 25% of respondents reported actively providing screening services in their facilities. Major barriers included a lack of training, limited screening equipment, and inadequate laboratory support. Significant associations were observed between levels of knowledge and professional category (p < 0.001), educational qualification (p = 0.033 ), and years of practice (p = 0.002 ).

Strengthening healthcare workers' capacity, improving infrastructure, and integrating screening into routine PHC services are essential for improving cervical cancer prevention. These findings highlight the need for policy interventions aimed at strengthening primary health care systems in Nigeria in line with global cervical cancer elimination strategies.