School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
Cancer Rep (Hoboken). 2022 May;5(5):e1514. doi: 10.1002/cnr2.1514. Epub 2021 Jul 27.
Cervical cancer is the most prevalent gynaecologic cancer in Nigeria. Despite being largely preventable through screening, cervical cancer is the second leading cause of cancer morbidity and mortality in Nigeria. To reduce the burden of cervical cancer in Nigeria, female health workers (FHWs) are expected to play an influential role in leading screening uptake and promoting access to cervical cancer education and screening.
The aim of this systematic review is to assess the factors influencing cervical cancer screening (CCS) practice among FHWs in Nigeria.
We conducted a systematic literature search across six (6) electronic databases namely MEDLINE, Embase, Scopus, African Index Medicus, CINAHL, and Web of Science between May 2020 and October 2020. Reference list and grey literature search were conducted to complement database search. Four reviewers screened 3171 citations against the inclusion criteria and critically appraised the quality of eligible studies. Narrative synthesis was used in summarising data from included studies.
Overall, 15 studies met the inclusion criteria and were all quantitative cross-sectional studies. Included studies sampled a total of 3392 FHWs in Nigeria. FHWs had a high level of knowledge and positive attitude towards CCS. However, CCS uptake was poor. Predominant barriers to CCS uptake were the cost of screening, fear of positive results, lack of test awareness, reluctance to screen, low-risk perception, and lack of time. In contrast, being married, increasing age, awareness of screening methods, and physician recommendation were the most documented facilitators.
This study revealed that a complex interplay of socioeconomic, structural, and individual factors influences CCS among FHWs in Nigeria. Therefore, implementing holistic interventions targeting both health system factors such as cost of screening and infrastructure and individual factors such as low-risk perception and fear of positive result affecting FHWs in Nigeria is critical to reducing the burden of cervical cancer.
宫颈癌是尼日利亚最常见的妇科癌症。尽管通过筛查可以在很大程度上预防宫颈癌，但它仍是尼日利亚癌症发病率和死亡率的第二大主要原因。为了减轻尼日利亚宫颈癌的负担，女性卫生工作者（FHW）有望在引领筛查参与度和促进获得宫颈癌教育和筛查方面发挥重要作用。
本系统综述旨在评估影响尼日利亚 FHW 进行宫颈癌筛查（CCS）的因素。
我们在 2020 年 5 月至 10 月期间在六个电子数据库（包括 MEDLINE、Embase、Scopus、非洲医学索引、CINAHL 和 Web of Science）中进行了系统文献检索。还进行了参考文献列表和灰色文献检索以补充数据库检索。四名评审员根据纳入标准筛选了 3171 条引用文献，并对合格研究的质量进行了批判性评估。采用叙述性综合法总结纳入研究的数据。
总体而言，有 15 项研究符合纳入标准，均为定量横断面研究。纳入的研究共对 3392 名尼日利亚 FHW 进行了采样。FHW 对 CCS 有较高的知识水平和积极的态度。然而，CCS 的参与度较低。阻碍 CCS 参与的主要因素是筛查费用、对阳性结果的恐惧、缺乏检测意识、不愿意筛查、低风险认知以及缺乏时间。相比之下，已婚、年龄增长、对筛查方法的认识以及医生的建议是最常被记录的促进因素。
本研究表明，复杂的社会经济、结构和个人因素相互作用影响尼日利亚 FHW 的 CCS。因此，在尼日利亚实施针对包括筛查成本和基础设施等卫生系统因素以及低风险认知和对阳性结果的恐惧等个人因素的综合干预措施对于减轻宫颈癌负担至关重要。
