American Journal of Cancer Prevention
ISSN (Print): 2328-7314 ISSN (Online): 2328-7322 Website: Editor-in-chief: Nabil Abdel-Hamid
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American Journal of Cancer Prevention. 2016, 4(2), 26-32
DOI: 10.12691/ajcp-4-2-2
Open AccessArticle

Sexual Behavioral Pattern, Cervical Cancer Awareness and Screening Practices among Female Undergraduate Students of Public Universities in Anambra State, Nigeria

Valentine C Ilika1, Chinomnso C Nnebue2, , Ngozi N Ikechebelu3, Chito P Anyanwu4, Amobi L Ilika5 and Joseph I Ikechebelu6

1Department of Community Medicine, Chukwuemeka Odumegwu Ojukwu University Awka, Nigeria

2Department of HIV Care and Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

3Department of Community Medicine, Chukwuemeka Odumegwu Ojukwu University / University Teaching Hospital Awka, Nigeria

4Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

5Department of Community Medicine, Nnamdi Azikiwe University/University Teaching Hospital Nnewi, Nigeria

6Department of Obstetrics and Gynecology, Nnamdi Azikiwe University/University Teaching Hospital Nnewi, Nigeria

Pub. Date: July 18, 2016

Cite this paper:
Valentine C Ilika, Chinomnso C Nnebue, Ngozi N Ikechebelu, Chito P Anyanwu, Amobi L Ilika and Joseph I Ikechebelu. Sexual Behavioral Pattern, Cervical Cancer Awareness and Screening Practices among Female Undergraduate Students of Public Universities in Anambra State, Nigeria. American Journal of Cancer Prevention. 2016; 4(2):26-32. doi: 10.12691/ajcp-4-2-2


Background: Risky sexual behavior, low level of awareness and poor screening uptake have been linked to the high prevalence of cervical cancer in our environment. Objective: To determine the sexual behavioral pattern, cervical cancer awareness and screening practices among female undergraduate students of public universities in Anambra state, Nigeria. Materials and methods: This was a descriptive cross sectional study of 342 female undergraduate students in Anambra state, Nigeria selected using a two stage sampling. Data was collected using a pre-tested semi-structured questionnaire and analysed using statistical package for social sciences version 22.0. Chi-square test was used to identify statistically significant associations between variables. A p value of ≤ 0.05 was considered significant. Results: The modal age at menarche, 215 (62.9%) was 13-15 years, while 18 (5.3%) first menstruated at ages below 10 years. Of the 311 (71.6%) that ever had sex, 289 (92.9%) had their coitarche at ages below 24 years, 209 (67.2%) were sexually active while 48 (15.4%) had multiple sex partners. About 310 (90.6%) have heard of cervical cancer, 269 (78.8%) were aware of cervical cancer screening, out of which 108 (40.2%) were aware of cervical cancer screening tests with Pap smear as the most mentioned screening test by 55 (51.0%). There were statistically significant associations between uptake of cervical cancer screening and [ever been pregnant (p=0.005), ever used contraceptives (p=0.001) and perceived need for cervical cancer screening (p=0.000) respectively. Conclusions: This study showed a good level of awareness of cervical cancer but cervical cancer screening practices was inadequate. We recommend educational programs and comprehensive cervical cancer screening strategy.

cervical cancer awareness screening practices sexual behavior female undergraduates Anambra state Nigeria

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[1]  Adefuye PO. Knowledge and practice of cervical screening among professional health workers in a suburban district in Nigeria. Nigerian Medical Practitioner.2006;50:19-22.
[2]  Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al., Estimated cancer incidence, mortality and prevalence worldwide in 2012. GLOBOCAN. 2012.Available@,v1.0, [Accessed on 22 May, 2016].
[3]  Forouzanfar MH, Foreman KJ, Delossantos AM, Lozano R, Lopez AD, Murray CJ, et al., Breast and cervical cancer in 187 countries between 1980 and 2010: A systematic analysis. Lancet.2011;378 (9801):1461-84.
[4]  Africa Health, Human and Social Development Information Service (Afri--‐Dev. Info i.e. Formerly Africa Public Health .Info), Africa Coalition on Maternal Newborn and Child Health. Summary scorecard and research findings at end of scorecard including: Global/Africa Continental/Sub Regional and Country trends; and links with Sexual and Reproductive Health (SRH), HIV/AIDS, Adolescent and Maternal Health. Advancing multi-sectoral policy and investment for girls, women and children’s health. 2014. [Accessed on 22 May, 2016].
[5]  Jedy-Agba E, Curado MP, Ogunbiyi O, Oga E, Fabowale T, Igbinoba F, et al., Cancer incidence in Nigeria: a report from population-based cancer registries. Cancer Epidemiol. 2012; 36(5): e271-8.
[6]  Bayo S, Bosch FX, de Sanjose S, Munoz N, Combita AL Coursage P, et al. Risk factors of invasive cervical cancer in Mali. International Journal of Epidemiology 2002; 31:202-9.
[7]  Muñoz N, Fransceschi S, Bossetti C, Moreno V, Herrero R Smith JS, et al. Role of parity and human papillomavirus in cervical cancer: The IARC Multicentric Case-Control Study. Lancet 2002;359:1093-101.
[8]  World Health Organization (WHO). Comprehensive cervical cancer control: A guide to essential practice. Screening for cervical cancer. Geneva, WHO Press.2002.
[9]  Adjorlolo-Johnson G, Unger ER, Boni-Ouattara E, Coulibaly KT, Maurice C, Vernon SD, et al.,. Assessing the relationship between HIV infection and cervical cancer in Côte d’Ivoire: A case–control study. BMC Infect. Dis. 2012;10:242.
[10]  Mbamara SU, Ikpeze OC, Okonkwo JE, Onyiaorah IV, Ukah CO. Knowledge, attitude and practice of cervical cancer screening among women attending gynecology clinics in a tertiary level medical care center in southeastern Nigeria. J Reprod Med. 2011;56(11-12):491-6.
[11]  Program for Appropriate Technology in Health. Planning appropriate cervical cancer prevention programs, 2nd edition. Seattle, 2000.
[12]  Sherris J, Castro W, Lewin C, Dzuba I, Arossi S. The case for investing in cervical cancer prevention. Cervical Cancer Prevention Issues in Depth no. 3. Alliance for Cervical Cancer Prevention. 2004, Seattle. Available@ RH_accp _case.pdf. [Accessed on 22 May, 2016].
[13]  Nnebue CC. The Epidemiological transition: policy and planning implications for developing countries. Niger J Med. 2010; 19(3): 250-6.
[14]  World Health Organization. Human papillomavirus and cervical Cancer. 2010. Available@[Accessed on 22 May, 2016].
[15]  Naseema BA, Smitha SK. Awareness of cervical cancer and Pap smear and it’s utilization among health care workers in medical college, Kozhikode. Journal of Evidence Based Medicine and Healthcare.2014;1(2):48-53.
[16]  Peirson L, Fitzpatrick-Lewis D, Ciliska D, Warren R. Screening for cervical cancer: a systematic review and meta-analysis. Syst Rev.2013;2:35.
[17]  Dang J, Lee J, Tran JH. Knowledge, attitudes, and beliefs regarding breast and cervical cancer screening among Cambodian, Laotian, Thai, and Tongan Women. J Cancer Educ.2010: 25: 595-601.
[18]  World Health Organization. Comprehensive cervical cancer control: A guide to essential practice. Geneva, Switzerland. 2005a.p.272.
[19]  World Health Organization (WHO). WHO guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Geneva, Switzerland: WHO.2013.
[20]  Pan American Health Organization. Situational analysis of cervical cancer prevention and control in the Caribbean: results from a 2013 assessment of country policies and services for HPV vaccination, cervical cancer screening, diagnosis and treatment. 2013.
[21]  Botha H, Cooreman B, Dreyer G, Lindeque G, Mouton A, Guidozzi F, et al. Cervical cancer and human papillomavirus: South African guidelines for screening and testing. South Afr J Gynaecol Oncol.2010; 2:23-26.
[22]  The United States Preventive Services Task Force (USPSTF). Screening for cervical cancer: clinical summary of USPSTF recommendation. AHRQ Publication No. 11-05156-EF-3, March 2012. Available@: cervcancersum.htm. [Accessed on 22 May, 2016].
[23]  American Cancer Society. Screening guidelines for the prevention and early detection of cervical cancer. American Cancer Society, Atlanta, Ga.2012. Available@ [Accessed on 22 May, 2016].
[24]  Pengpid S, Peltzer K. Attitudes and practice of cervical cancer screening among female university students from 25 low, middle income and emerging economy countries Asian Pacific Journal of Cancer Prevention.2014;15:7235-9.
[25]  Akujobi CN, Ikechebelu JI, Onunkwo I, Onyiaorah IV. Knowledge, attitude and practice of screening for cervical cancer among female students of a tertiary institution in South Eastern Nigeria. Niger J Clin Pract.2008;11:216-9.
[26]  Aniebue PN, Aniebue UU. Awareness and practice of cervical cancer screening among female undergraduate students in a Nigerian university. J Cancer Educ.2010;25: 106-8.
[27]  Ayinde OA, Omigbodun AO, Ilesanmi AO. Awareness of cervical cancer, papanicolaou’s smear and its utilisation among female undergraduates in Ibadan. Afr J Reprod Hlth,2004;8:68-80.
[28]  Oladepo O, Ricketts OL, John-Akinola Y. Knowledge and utilization of cervical cancer screening services among Nigerian students. Int Q Community Health Educ.2008/9;29:293-304.
[29]  Abotchie PN, Shokar NK. Cervical cancer screening among college students in Ghana: knowledge and health beliefs. Int J Gynecol Cancer.2009;19:412-6.
[30]  Dhendup T, Tshering P. Cervical cancer knowledge and screening behaviors among female university graduates of year 2012 attending national graduate orientation program, Bhutan. BMC Womens Health.2014;14:44.
[31]  Bakogianni GD, Goutsou SC, Liti MV, Rizopoulou SI, Nikolakopoulos KM, Nikolakopoulou NM. Knowledge, attitude, and practice of cervical cancer screening among Greek students: a short report. Int J Adolesc Med Health.2012;24:329-30.
[32]  Durvasula 7238 Durvasula RS, Regan PC, Ureño O, Howell L (2006). Frequency of cervical and breast cancer screening rates in a multi-ethnic female college sample. Psychol Rep.2006;99:418-20.
[33]  Hyacinth HI, Adekeye OA, Ibeh JN, Osoba T. Cervical cancer and Pap smear awareness and utilization of pap smear test among Federal civil servants in North Central Nigeria. PLoS One.2012;7(10):e46583.
[34]  Araoye MO. Research methodology with statistics for health and social sciences. Nathadex Publications, saw-mill, Ilorin 2nd ed.2008:p 115- 22.
[35]  Statistical Package for Social Sciences (IBM SPSS) 22.0 version. Armonk NY: IBM United States. IBM Corp. 2013.
[36]  Kishore J, Mundra V, Grewal I. Perception and use of Pap smear among medical personnel in New Delhi, India. Health and Population: Perspectives and Issues.2009;32:141-147
[37]  Ezem B U. Awareness and uptake of cervical cancer screening in Owerri, South-Eastern Nigeria. Ann Afr Med.2007;6:94-8.
[38]  Bukar M Takai IU , Audu BM .Determinants of utilization of papanicolaou smear among outpatient clinic attendees in north-eastern Nigeria. African Journal of Medicine and Medical Sciences.2012;41(2):183-9
[39]  Onajole AT, Ajekigbe AT, Bamgbala AO, Odeyemi KA, Ogunnowo BO, Osisanya TF, et al. The socio-demographic characteristics and level of awareness of prevention of cancer of the cervix among commercial sex workers in Lagos, Nigeria. Nigerian Medical Practitioner.2004;45:52-5.
[40]  Duru CB, Abejegah C, Nnebue CC, Uwakwe KA, Obi- Okaro AC, Azuogu BC. Heterosexual behaviour, awareness and practice of cervical cancer screening among female staff and students in a private tertiary institution in South-south, Nigeria. Indian Journal of Medical Research and Pharmaceutical Sciences. 2014;1(6):1-9.
[41]  Obiechina NJ, Mbamara SU. Knowledge attitude and practice of cervical cancer screening among sexually active women in Onitsha, southeast Nigeria. Niger J Med. 2009;18(4):384-7.