Assessment of Knowledge and Attitude of Reproductive Age Women towards Cervical Cancer Prevention in Selected Tertiary Institutions in Osun State, Nigeria

Assessment of Knowledge and Attitude of Reproductive Age Women towards Cervical Cancer Prevention in Selected Tertiary Institutions in Osun State, Nigeria | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Knowledge and Attitude of Reproductive Age Women towards Cervical Cancer Prevention in Selected Tertiary Institutions in Osun State, Nigeria Adeyemi Ogedengbe Omoge, Oluwabunmi Bridget Erinsakin, Oladunni Opeyemi, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7177575/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Cervical cancer remains a prevalent issue among reproductive-age women, with limited preventive practices observed in Nigeria. Cervical cancer is ranked as the second most common cancer among women aged 14 to 49 globally, including Nigeria. Developed countries have successfully reduced cervical cancer rates through effective screening and vaccination programs, which are underdeveloped and inefficient in Nigeria and many other developing nations. Objectives This study aimed to assess the knowledge and attitudes of reproductive age women regarding cervical cancer prevention within selected tertiary institutions in Osun State, Nigeria. Methodology: A descriptive cross-sectional study was conducted involving 396 participants recruited through a multistage sampling. among reproductive age women in Osun State's selected tertiary institutions. Data was collected using a self-administered, questionnaire and analysed using SPSS version 21. Results The average age of respondents was 25.305 ± 8.195. 79.0% were Christians, and 21.0% were Muslims. While 52% had adequate knowledge, attitudes were generally negative, and only 23% engaged in preventive behaviours like HPV vaccination or screening. Statistical analysis showed no significant relationship between knowledge, attitude, and practice, suggesting that awareness alone does not influence behaviour. Conclusion These findings highlight a need for targeted interventions that address cultural and organizational barriers to improve prevention uptake. Public health policies prioritizing HPV awareness and increased access to preventive services are recommended to reduce cervical cancer risks in this demographic. Knowledge Attitude Women of Reproductive Age Cervical Cancer Prevention Introduction Cervical cancer (CC) is a cancer of the cervix, the cervix is a female reproductive organ connecting the uterus and the vagina. The human papilloma virus (HPV) is the primary cause of cervical cancer. According to ASCO (2020) [ 1 ] , cervical cancer begins on the cells on the surface of the cervix once infected with the human papilloma virus. Long-term infection of HPV on the cervix may result in cancer, resulting in a lump or tumour on the cervix. Tumours can be malignant or non-malignant. A malignant tumour has the ability to spread to other body parts, whereas a benign tumour, also known as a non-malignant tumour, is one that will not spread. [ 1 ] The human papillomavirus (HPV) is a sexually transmitted infection that can be acquired through vaginal, oral, or anal sex or through body-to-body contact with an infected person during sexual intercourse. Most people infected with HPV do not develop cancer, but the infection can raise the risk, especially in people with compromised immune systems. Cervical cancer is the most common genital cancer in women and one of the leading causes of death. Fortunately, this cancer can be avoided by getting vaccinated before starting sexual activities and getting screened for premalignant lesions starting at the age of 21, but in developing countries, these services are scarce and infrequently used. [ 2 ] In addition, Cervical Cancer has been identified as the leading cause of cancer-related death among women in developing countries. [ 3 ] Cervical Cancer is the second most common disease in women worldwide, with an estimated 528,000 new cases and 266,000 deaths per year in 2008, 530,000 new cases of cervical cancer were diagnosed worldwide, with 275,000 fatalities. [ 4 ] Surprisingly, the majority of these deaths happened in developing countries. In the same year, the WHO African region reported an additional 75,000 cases. [ 5 ] More so, an estimated 10,000 new instances of cervical cancer are recorded in Nigeria, with 8000 female mortality each year according to International Agency for Research on Cancer (2012). [ 6 ] Women with a weakened immune system, such as those living with HIV, have a higher rate of HPV infection than women who do not have HIV, according to previous research. [ 7 ] This is because the immune system isn’t fit enough to ward of the effect of HPV as it’s already subjected to other viruses, hence the need to take the preventive practices of cervical cancer (CC) with utmost seriousness. The ravaging situation of cervical cancer in Nigeria owes its high prevalence and mortality rate to the combination of the ignorance on preventive measures both primary and secondary, and unwillingness to use the preventive measures even when they are aware of it. This condition is crucial since there is a scarcity of infrastructure for effective treatment of invasive cervical cancer, especially when it is discovered late in the disease's progression. The majority of malignancies in Nigeria are discovered late in their progression, with a low chance of survival. [ 8 ] The incidence of cervical cancer is quite low in prosperous countries. The situation in developing countries, on the other hand, is considerably different. While the former is becoming less prevalent, the latter is gaining popularity. [ 9 ] This is most likely due to a low percentage of women getting vaccinated, Pap smears, poor knowledge, negative attitude and lack of awareness among women. [ 10 ] Pap smear screening (A screening for cervical cancer) should begin at age 21 according to Saslow et al., (2012). [ 11 ] As a result, regardless of the age of sexual initiation or other behaviour-related risk factors, women below 21years should not be checked. Furthermore, according to WHO (2014) [ 12 ] , screening for cervical cancer among women between 30 and 49 years, for at least once, will decrease mortality rate from cervical cancer. Human papillomavirus (HPV), a sexually transmitted virus, has been identified as the causative agent. The new cervical cancer prevention strategy focuses on immunizing against this HPV infection prior to the first sexual exposure as a type of primary prevention, or screening for evidence of pre-invasive cervix lesions as a type of secondary prevention. [ 13 ] meanwhile, these services are not part of the national immunization schedule. The prices of getting vaccinated against human papilloma virus and getting screened for premalignant lesions are not pocket friendly due to the current economy. Hence our reason to conduct this study among reproductive age women to create awareness, and increase their knowledge on HPV and its risk so they can abstain from premarital sexual activities prior vaccination, and also to go for screening three to four times between the age of 21–49 if they’ve been exposed to sexual activities so as to lower the risk of CC. Furthermore, to implore the government to put the lives of Nigerian women into consideration by birthing these services in the national immunization schedule. Conceptual Framework The Knowledge-Attitude-Practice (KAP) Model forms the foundation of the study’s conceptual framework, aiming to understand the relationships between awareness, beliefs, and actions towards cervical cancer prevention. Below is a detailed breakdown: 1. Knowledge: Knowledge represents an individual’s understanding of cervical cancer, including its causes (e.g., HPV), risk factors (e.g., multiple sexual partners), and preventive measures (e.g., vaccines and Pap smears). The study assesses this through questions like whether respondents have heard of HPV vaccines or understand how HPV is transmitted. While many respondents are aware of cervical cancer and its link to HPV, detailed understanding (e.g., the role of Pap smears) remains limited. 2. Attitude: Attitudes reflect respondents’ beliefs, perceptions, and readiness to engage in preventive practices. In this study, attitudes were shaped by: i. Misconceptions, such as believing HPV vaccines are for sick individuals only. ii. Cultural beliefs, such as associating screening with immorality or stigmatization. Negative attitudes often stem from partial or inaccurate information, emphasizing the need for trusted sources to reshape perceptions. 3. Practice: Practice refers to the actual engagement in preventive behaviours, such as HPV vaccination and cervical screening. Despite moderate knowledge levels, only a minority of respondents took preventive actions, pointing to significant barriers. Practices are often influenced by: i. Socioeconomic Barriers: High costs of vaccines and tests. ii. Healthcare Accessibility: Limited availability of services, especially in rural areas. iii. Cultural Resistance: Reluctance to discuss or address sexual health openly. 4. Influencing Factors: i. Economic Barriers: Financial constraints make HPV vaccines and screenings unaffordable for many women. ii. Healthcare System Limitations: Inadequate integration of cervical cancer prevention into routine healthcare services exacerbates the problem. iii. Cultural and Social Norms: Cultural stigmas around sexual health and preventive screenings discourage women from seeking help. iv. Information Quality: The role of healthcare professionals and accurate media representation is vital in countering misconceptions. Methodology Study Design A descriptive cross-sectional study was employed to carry out the study. The study was conducted among female undergraduates in selected tertiary institutions in Osun State. The institutions were selected using a simple random sampling technique by balloting. The selected institutions are: Adeleke University Ede Osun state, Redeemer’s University Ede Osun State, and Osun State University, Oshogbo Osun State. 396 female participants were selected using a multistage sampling technique. This method was chosen to ensure a representative sample of reproductive-age women from both institutions, thereby enhancing the generalizability of the study findings. Study Setting This study was conducted in selected tertiary institutions in Osun State, Nigeria, specifically Adeleke University, Redeemer’s University, and Osun State University. Osun State, located in southwestern Nigeria, has a significant population of young women enrolled in higher education, providing an ideal setting to assess reproductive-age women’s knowledge, attitudes, and practices regarding cervical cancer prevention. Conducting this research in tertiary institutions is essential because college-aged women represent a critical demographic for cervical cancer prevention due to their increased likelihood of being sexually active and their potential openness to health information and interventions. However, studies have shown that, despite their accessibility to educational resources, young women in Nigeria often lack adequate knowledge about cervical cancer and its prevention. By focusing on institutions in Osun State, this study aims to highlight the gaps in knowledge, attitude, and preventive practices among a diverse group of educated young women. Findings from this research can inform targeted health education initiatives and policies in academic settings, helping to foster awareness and proactive health behaviours that may reduce cervical cancer risks in this vulnerable population. Target Population The target population included female undergraduate attending various tertiary institutions in Osun State. However, the assessed population included Osun State University (Oshogbo Chapter), Redeemers University and Adeleke University Ede, Osun State. Inclusion and Exclusion Criteria Inclusion Criteria: Female undergraduates between the ages of 15-49 who were around during the period of conducting this study. Exclusion Criteria: Potential respondents who declined consent to participate in the study were excluded. Sample Technique and Sample Size Determination A probability based multistage sampling technique was adopted to select the institutions and the respondents. Three (3) tertiary institutions were chosen by balloting, a simple random sampling technique to give institutions, both government owned and private owned in Osun State an equal chance of being chosen. Simple random sampling technique was adopted for the selection of faculties in each institution to give every faculty an equal chance of being chosen and two faculties from each institution were chosen by balloting. Questionnaires were distributed in the selected institutions in the respective faculties that were selected by balloting using proportionate sampling. The sample size for this study was calculated using Taro Yamane (1967) formula to obtain the sufficient sample size. This sample size was used because we dealt with a finite population. The formula applied is given as n = N / (1 + N (e) 2 ) Where n = Sample size, N = Total population under study, e = margin error and 1 = adjusted constant. Numbers were substituted for variables and a sample size of 377 was gotten 10% attrition rate was added and the total sample size was 415. Instrument for Data Collection The study adopted a primary source of data collection. The instrument was a Semi-structured questionnaire, designed to include both open-ended and close-ended questions. The questionnaire was categorized into four sections with 47 total variables. Data Analysis The information obtained were collated, examined for completion and was imputed into IBM SPSS version 21 for analysis. Percentages, frequencies, tables and charts were used to analyse and present data related to objectives and socio-demographic characteristics. To assess the level of knowledge, knowledge questions were scaled and scored and categorized to the best midline such that 0-11(first half) was coded as poor knowledge and 12-23 (second half) as good knowledge, to assess the level of attitude, attitude questions were scaled and scored and categorized to the best midline such that 0-5(first half) was coded as negative attitude and 6-11(second half) as positive attitude. All right responses were coded as 1 and all wrong responses were coded as 0. Chi-square was used to test the association between the knowledge and practice of cervical cancer prevention as well as attitude and practice of cervical cancer prevention among reproductive age women in the selected institutions in Osun state. The level of significance was set at 0.05. Decision rule is that at p value less or equal to 0.05, hypothesis was considered statistically significant and greater than 0.05 was considered statistically not significant. Validity and Reliability of Instrument The question undergone face and content validity by our research supervisor, who scrutinized the items and ensured they captured the true picture of variables under the study. Her comment and observation were used to revisit the questionnaire before the final draft. Reliability was determined through a pre-test carried out among 42 female students in federal polytechnic Ede, Osun State. Reliability test for level of knowledge variables was conducted using Cronbach’s alpha with intra-class coefficient value of 0.72. Reliability test for level of attitude variables was conducted using Cronbach’s alpha with intra-class coefficient value of 0.76 Ethical Approval Ethical approval for this study was obtained from the research and ethics committee of Adeleke University and letters of permission was retrieved and submitted to the registrars of the selected tertiary institutions. Only willing individuals were interviewed, informed consent was obtained before interviewing respondents and they were treated with respect. Confidentiality of all respondents and information obtained in the course of this survey was ensured and maintained. Results Table 3 Attitude of Respondents on Cervical Cancer Prevention (n=396) s/n Variables SA A N D SD 1 Human papilloma virus vaccine is meant for unhealthy individuals only F 74 78 51 95 98 % 18.7 19.7 12.9 24.0 24.7 2 Cervical cancer screening is meant for only those who are sick F 43 51 33 101 168 % 10.9 12.9 8.3 25.5 42.4 3 Having multiple sexual partners can increase the risk of cervical cancer F 155 155 59 21 6 % 39.1 39.1 14.9 5.3 1.5 4 HPV is transmitted through sexual intercourse F 139 141 94 17 5 % 35.1 35.6 23.7 4.3 1.3 5 HPV can increase the risk of cervical cancer F 140 114 73 57 12 % 35.4 28.8 18.4 14.4 3.0 6 Early marriage onset is a risk to cervical cancer F 87 105 76 87 41 % 22.0 26.5 19.2 22.0 10.4 7 Cervical cancer is a major health problem for women F 166 98 66 46 20 % 41.9 24.7 16.7 11.6 5.1 8 Early diagnosis of premalignant lesions is good for treatment outcome F 183 126 63 24 0 % 46.2 31.8 15.9 6.1 0.0 9 Cervical cancer is preventable F 188 117 62 8 21 % 47.5 29.5 15.7 2.0 5.3 10 Cervical cancer is curable F 137 117 51 45 46 % 34.6 29.5 12.9 11.4 11.6 11 Early screening can help detect the onset of premalignant lesions F 167 105 66 21 37 % 42.2 26.5 16.7 5.3 9.3 Table 4 Association between Knowledge of Reproductive Age Women and Prevention of Cervical Cancer Categories Knowledge on Cervical Cancer prevention χ 2 p-value Decision Low High Prevention of cervical cancer Good 153 152 2.537 .121 Not sig. Poor 37 54 Table 5 Association between Attitude of Reproductive Age Women and Prevention of Cervical Cancer Categories Attitude towards cervical cancer prevention χ 2 p-value Decision Negative Positive Prevention of cervical cancer Good 158 147 .025 .905 Not sig. Poor 48 43 Discussion Socio-Demographic Characteristics of Participants The mean age of respondents was 25.305±8.195. 79.0% were Christians, 82.1% were Yoruba. 97.5% were full time students, 48.5% were from 100 level, and 93.9% were single. Overall Results revealed that 52.0% had good knowledge of cervical cancer prevention. 77.0% had bad practice towards cervical cancer prevention, and 52.0% had negative attitude towards cervical cancer prevention. Knowledge on Cervical Cancer Prevention The study highlights that only 52% of the study respondents have adequate knowledge of cervical cancer prevention, while 48% lack sufficient awareness. This indicates a substantial gap in knowledge despite the presence of health information sources, pointing to missed opportunities for education and awareness-building among this population. This result is consistent with findings from Adebayo et al. (2021) [14] , who noted similar knowledge levels (60.6%) among antenatal attendees in Ibadan, and Ekwonwa et al. (2017) [15] , where knowledge levels were even higher (72.8%) among reproductive-age women in Ede South. This pattern suggests that women within healthcare settings, like antenatal clinics, may have more access to cervical cancer information than those in other environments. However, the results contrast with Ogbonna (2017) [16] , where less than half of the respondents displayed adequate knowledge. This discrepancy may reflect differences in education access, geographic or socioeconomic backgrounds, and healthcare exposure across study populations. Although most respondents in the article’s study were aware of the HPV vaccine and the benefits of early screening, many were unfamiliar with the terminology, such as what a Pap smear is. This detail signals potential deficiencies in the clarity and comprehensiveness of health messaging, where specific terms and procedural information may not be fully explained or emphasized, possibly leading to misunderstandings about preventive measures. Health workers and media emerged as the most common sources of information for the study respondents, consistent with findings by Duru et al. (2015) [17] and Ilika (2016) [18] . This reliance on health workers underscores the critical role healthcare professionals play in disseminating accurate health information. However, the mass media’s significant influence highlights both an opportunity and a challenge: while media can reach large audiences, it can also convey unfiltered or incorrect information. This risk may partially explain why knowledge and attitudes toward cervical cancer prevention remain inconsistent or limited. Attitude Towards Cervical Cancer Prevention While knowledge is moderate, attitudes toward cervical cancer prevention were notably negative in over half (52%) of the respondents. This outcome contrasts with Mullatu et al. (2017) [19] , where a majority of female students at Mizan Tepi University held positive attitudes. The article attributes this difference to unfiltered information, particularly from non-healthcare sources, that may foster misconceptions. This finding reflects a broader issue where partial or inaccurate information can hinder preventive attitudes, as also noted by Sajid et al. (2019) [20] , who reported that over half of their respondents’ believed screening was unnecessary without symptoms. This underscores the need for accurate, trusted health information to shift attitudes positively. Negative attitudes among respondents could contribute to low engagement in preventive behaviours, as individuals are less likely to seek services they do not prioritize or fully understand. The practice of preventive behaviours like screening and HPV vaccination is markedly low among the respondents, with 77% showing poor preventive practices. Despite having some knowledge, most respondents have not acted on it, as evidenced by 74.5% who never underwent HPV testing , 72.5% who never received the HPV vaccine , and 58.6% who never participated in cervical cancer screening . This gap between knowledge and practice is consistent with other studies, such as Nowomuhangi (2019) [21] , where only half of the first-year nursing students had undergone screening, and Rahmat, A. et al. (2021) [22] , which found a 30% screening uptake among respondents. This pattern suggests a systemic issue across Africa, where knowledge is present but does not translate into action due to barriers like access to healthcare, affordability of preventive measures, cultural beliefs, and potentially low risk perception. Association between Knowledge and Attitude of Reproductive Age Women and Prevention of Cervical Cancer The chi-squares results showed that there is no significant association between knowledge and practices of cervical cancer screening and vaccine intake towards cervical cancer prevention (χ 2 = 2.537 a ; p-value= .121; df =1), attitude and practices of cervical cancer prevention (χ 2 = .025 a ; p-value= .905; df =1). This result implies that, attitude is not a predictor as regards cervical cancer prevention and the knowledge demonstrated by the respondents do not have effect on the practice of cervical cancer prevention. Implications for Assessment of Knowledge and Attitude The findings underscore a critical need for enhanced education and practical interventions to bridge the knowledge-attitude-practice gap. Health programs must focus on clear communication, addressing misconceptions, and creating accessible channels for screening and vaccination. Additionally, policy measures that subsidize or integrate HPV vaccines and screenings into regular health services could significantly improve preventive practice uptake. These actions would address the practical challenges that hinder behaviour change, helping align knowledge and attitude with consistent preventive practices. In summary, while this study reveals that awareness is present among reproductive-age women, barriers rooted in information quality, cultural context, and systemic healthcare access issues prevent this knowledge from translating into preventive actions. These insights indicate a need for tailored health interventions that directly address the structural and cultural barriers to cervical cancer prevention in Nigeria and similar settings. Conclusion The study revealed significant gaps in knowledge, attitudes, and practices toward cervical cancer prevention among reproductive-age women in selected tertiary institutions in Osun State. Although 52% demonstrated adequate knowledge of cervical cancer prevention, this awareness did not translate into preventive actions, with 77% of the respondents reporting poor practices. Furthermore, 52% of the participants exhibited a negative attitude toward cervical cancer prevention, suggesting that awareness alone is insufficient to encourage proactive health behaviours. Major sources of information included health workers and media, yet the study identified that misconceptions from non-health sources may negatively impact preventive attitudes. These findings suggest that increasing knowledge alone may not lead to improved health behaviours without addressing underlying cultural, social, and systemic barriers. Misconceptions about cervical cancer screening and the HPV vaccine, fuelled by inadequate health information or partial understanding, can result in negative attitudes that discourage preventive actions. The observed disconnect between knowledge and practice calls for more targeted health education initiatives that address cultural stigmas, provide accurate information, and foster positive attitudes toward cervical cancer prevention. These findings underscore a complex interplay between knowledge, cultural beliefs, attitudes, and systemic barriers, which collectively hinder the adoption of preventive measures. By understanding that knowledge and attitude gaps are deeply rooted in larger social and informational contexts, future interventions can be designed to support behaviour change more effectively. Recommendations To address the gaps identified in this study, the following recommendations are proposed: For Practice and Policy 1. Integrate Cervical Cancer Prevention into Institutional Health Programs: Establish routine health education sessions in tertiary institutions, focusing on cervical cancer awareness and the importance of preventive practices like screening and HPV vaccination. This can ensure sustained exposure to accurate information within academic environments. 2. Subsidize HPV Vaccination and Screening Costs: Advocate for policy interventions that make HPV vaccination and cervical cancer screenings more affordable and accessible. Including these services in Nigeria’s public health agenda can help overcome financial barriers that deter preventive practices. 3. Collaborate with Trusted Community Leaders and Healthcare Professionals: Partner with local healthcare providers and community influencers to build trust and improve the credibility of cervical cancer education, making it easier to address and overcome cultural and social barriers. For Health Education and Public Awareness 1. Enhance Clarity and Accessibility of Health Information: Develop clear and accessible educational materials that demystify cervical cancer prevention terminology, such as explaining Pap smear testing. This will help bridge knowledge gaps, particularly among those unfamiliar with medical terminology. 2. Use Media to Promote Positive Health Behaviours: Leverage mass media and social media platforms to disseminate reliable health information and debunk misconceptions. Campaigns can be tailored to target young women in tertiary institutions, using relatable messaging and testimonials to foster positive attitudes toward preventive actions. 3. Implement Interactive Workshops and Peer Education Programs: Host interactive sessions, such as workshops and peer-led education programs, where women can openly discuss misconceptions, address cultural beliefs, and learn about cervical cancer prevention in an engaging and supportive environment. For Future Research and Development 1. Explore Additional Factors Affecting Behaviour Change: Conduct further studies to examine unaddressed variables like motivation, healthcare access, and the impact of socioeconomic status on preventive behaviour. These insights can inform more tailored interventions that effectively convert knowledge and attitude into action. 2. Evaluate Health Education Strategies: Implement pilot programs testing different health education approaches and monitor their effectiveness in changing knowledge, attitudes, and practices. This data can help optimize cervical cancer awareness programs and identify the most impactful communication strategies. By implementing these recommendations, public health stakeholders and educational institutions can create a supportive environment for cervical cancer prevention, ensuring that knowledge and positive attitudes translate into tangible preventive actions among women in Nigeria and similar contexts. Declarations ETHICS APPROVAL AND CONSENT TO PARTICIPATE Ethical approval for this study was obtained from the research and ethics committee of Adeleke University and letters of permission was retrieved and submitted to the registrars of the selected tertiary institutions. Only willing individuals were interviewed, informed consent was obtained before interviewing respondents and they were treated with respect. Confidentiality of all respondents and information obtained in the course of this survey was ensured and maintained. CONSENT FOR PUBLICATION All participants provided an informed consent for the anonymised data to be published as part of this study. COMPETING INTERESTS All authors declare that there is no competing interest. FUNDING INFORMATION No funding received for the study. Author Contribution All authors contributed to the research Acknowledgement All authors are acknowledged AVAILABILITY OF DATA AND MATERIALS The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request. References American society of clinical oncology. (2020). Cervical cancer Diagnosis and Stages. Knowledge Conquers Cancer Saad A., Kabiru S., Suleiman H., Rukaiya A. (2013). Knowledge, Attitude and Practice of Cervical Cancer Screening among Market Women in Zaria, Nigeria. Nigeria medical Journal vol.54 Amine, C., Sanaa EL M., Nabil, I., Zakia, C., Jamal, B., Chakib, N., Amine EL H., Yahya C. and Noureddine, B. (2016). Evaluation of the Cost of Cervical Cancer at the National Institute of Oncology, Rabat. Pan African Medical Journal. Vol. 23 Globocan. (2012). 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Assessment of Knowledge, Attitude and Practice on Cervical Cancer Screening among Female Students of Mizan Tepi University, Ethiopia. Cancer Biol Ther Oncol. Sajid et al., (2019). Knowledge, Attitude and Practice towards cervical cancer screening among female health care professionals Nowomuhangi B. (2019). Knowledge, Attitude and Practice on Cervical Cancer and Screening among First Year Female Nursing Students of Kampala international university. Rahmat, A., Abimbola, O., and Olaide E. (2021). Predictors of Uptake of Cervical Cancer Screening among Nurses in Ogbomoso, Nigeria. African Journal of Midwifery and Women’s Health. Vol. 15 Tables 1 and 2 Tables 1 and 2 are available in the Supplementary Files section. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7177575","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":494063680,"identity":"eec8da86-0fc3-4a9b-b58d-e0a9600b3e69","order_by":0,"name":"Adeyemi Ogedengbe Omoge","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYPACZjB54AOQYGMnRcvBGSAtzKRoYeZBsHEDfrHDh198qLGWMzjenXjY5tc2eT5mBsYPH3Nwa5GcnZZmOeNYurHBmbMbDuf23TZsY2Zglpy5DbcWg9s5ZsY8bIcTN9zIBWrpuc0I1MLGzEtIy59/h+s33H+74bBlz217YrQYP2ZsO5xgcIN3w2GGH7cTCWoB+YWxty/dcOaZ3A0HextuJ7cxMzbj9Qu/dPLhDz++WcvzHT+7+cOPP7dt57c3H/zwEY8WIGCTAJEKB4AEYxuIydiAVz0QMIOSCYM8WN0fQopHwSgYBaNgJAIAybdZX5n9H2oAAAAASUVORK5CYII=","orcid":"","institution":"University of Oviedo","correspondingAuthor":true,"prefix":"","firstName":"Adeyemi","middleName":"Ogedengbe","lastName":"Omoge","suffix":""},{"id":494063681,"identity":"c7584bc3-39c5-4c6d-9520-0496fa28b2ac","order_by":1,"name":"Oluwabunmi Bridget Erinsakin","email":"","orcid":"","institution":"Adeleke University","correspondingAuthor":false,"prefix":"","firstName":"Oluwabunmi","middleName":"Bridget","lastName":"Erinsakin","suffix":""},{"id":494063682,"identity":"6b49b43d-877f-4c5a-bf60-7873793b2680","order_by":2,"name":"Oladunni Opeyemi","email":"","orcid":"","institution":"Adeleke University","correspondingAuthor":false,"prefix":"","firstName":"Oladunni","middleName":"","lastName":"Opeyemi","suffix":""},{"id":494063683,"identity":"d5fcec99-0a34-410f-affd-a3c3185f9d5b","order_by":3,"name":"Idowu Abimbola Olumakinde","email":"","orcid":"","institution":"Adeleke University","correspondingAuthor":false,"prefix":"","firstName":"Idowu","middleName":"Abimbola","lastName":"Olumakinde","suffix":""},{"id":494063684,"identity":"2efe6655-f740-4469-bbd7-2444b34d9a21","order_by":4,"name":"Busayomi Elizabeth Folashayo","email":"","orcid":"","institution":"Adeleke University","correspondingAuthor":false,"prefix":"","firstName":"Busayomi","middleName":"Elizabeth","lastName":"Folashayo","suffix":""},{"id":494063685,"identity":"fd0da1bf-cc43-4bba-abcc-3dc9588d9726","order_by":5,"name":"Philip Michael Nanle","email":"","orcid":"","institution":"Adeleke University","correspondingAuthor":false,"prefix":"","firstName":"Philip","middleName":"Michael","lastName":"Nanle","suffix":""}],"badges":[],"createdAt":"2025-07-21 12:38:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7177575/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7177575/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95526231,"identity":"b34174cc-6e40-439e-813b-d03dd270432f","added_by":"auto","created_at":"2025-11-10 10:06:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":987457,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7177575/v1/57159045-bb64-4a22-a316-82e54ffc33fa.pdf"},{"id":88239904,"identity":"cfc54fef-0606-478f-a5b8-0744f6b23544","added_by":"auto","created_at":"2025-08-04 11:07:10","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":25795,"visible":true,"origin":"","legend":"","description":"","filename":"Tables1and2.docx","url":"https://assets-eu.researchsquare.com/files/rs-7177575/v1/70c969371f8f3f0f00dc20ad.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of Knowledge and Attitude of Reproductive Age Women towards Cervical Cancer Prevention in Selected Tertiary Institutions in Osun State, Nigeria","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCervical cancer (CC) is a cancer of the cervix, the cervix is a female reproductive organ connecting the uterus and the vagina. The human papilloma virus (HPV) is the primary cause of cervical cancer. According to ASCO (2020)\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e, cervical cancer begins on the cells on the surface of the cervix once infected with the human papilloma virus. Long-term infection of HPV on the cervix may result in cancer, resulting in a lump or tumour on the cervix. Tumours can be malignant or non-malignant. A malignant tumour has the ability to spread to other body parts, whereas a benign tumour, also known as a non-malignant tumour, is one that will not spread.\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe human papillomavirus (HPV) is a sexually transmitted infection that can be acquired through vaginal, oral, or anal sex or through body-to-body contact with an infected person during sexual intercourse. Most people infected with HPV do not develop cancer, but the infection can raise the risk, especially in people with compromised immune systems. Cervical cancer is the most common genital cancer in women and one of the leading causes of death. Fortunately, this cancer can be avoided by getting vaccinated before starting sexual activities and getting screened for premalignant lesions starting at the age of 21, but in developing countries, these services are scarce and infrequently used.\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eIn addition, Cervical Cancer has been identified as the leading cause of cancer-related death among women in developing countries.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e Cervical Cancer is the second most common disease in women worldwide, with an estimated 528,000 new cases and 266,000 deaths per year in 2008, 530,000 new cases of cervical cancer were diagnosed worldwide, with 275,000 fatalities.\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e Surprisingly, the majority of these deaths happened in developing countries. In the same year, the WHO African region reported an additional 75,000 cases.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e More so, an estimated 10,000 new instances of cervical cancer are recorded in Nigeria, with 8000 female mortality each year according to International Agency for Research on Cancer (2012).\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e Women with a weakened immune system, such as those living with HIV, have a higher rate of HPV infection than women who do not have HIV, according to previous research.\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e This is because the immune system isn\u0026rsquo;t fit enough to ward of the effect of HPV as it\u0026rsquo;s already subjected to other viruses, hence the need to take the preventive practices of cervical cancer (CC) with utmost seriousness.\u003c/p\u003e\u003cp\u003eThe ravaging situation of cervical cancer in Nigeria owes its high prevalence and mortality rate to the combination of the ignorance on preventive measures both primary and secondary, and unwillingness to use the preventive measures even when they are aware of it. This condition is crucial since there is a scarcity of infrastructure for effective treatment of invasive cervical cancer, especially when it is discovered late in the disease's progression. The majority of malignancies in Nigeria are discovered late in their progression, with a low chance of survival.\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe incidence of cervical cancer is quite low in prosperous countries. The situation in developing countries, on the other hand, is considerably different. While the former is becoming less prevalent, the latter is gaining popularity.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e This is most likely due to a low percentage of women getting vaccinated, Pap smears, poor knowledge, negative attitude and lack of awareness among women.\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e\u003cp\u003ePap smear screening (A screening for cervical cancer) should begin at age 21 according to Saslow et al., (2012).\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e As a result, regardless of the age of sexual initiation or other behaviour-related risk factors, women below 21years should not be checked. Furthermore, according to WHO (2014)\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e, screening for cervical cancer among women between 30 and 49 years, for at least once, will decrease mortality rate from cervical cancer. Human papillomavirus (HPV), a sexually transmitted virus, has been identified as the causative agent. The new cervical cancer prevention strategy focuses on immunizing against this HPV infection prior to the first sexual exposure as a type of primary prevention, or screening for evidence of pre-invasive cervix lesions as a type of secondary prevention.\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e meanwhile, these services are not part of the national immunization schedule.\u003c/p\u003e\u003cp\u003eThe prices of getting vaccinated against human papilloma virus and getting screened for premalignant lesions are not pocket friendly due to the current economy. Hence our reason to conduct this study among reproductive age women to create awareness, and increase their knowledge on HPV and its risk so they can abstain from premarital sexual activities prior vaccination, and also to go for screening three to four times between the age of 21\u0026ndash;49 if they\u0026rsquo;ve been exposed to sexual activities so as to lower the risk of CC. Furthermore, to implore the government to put the lives of Nigerian women into consideration by birthing these services in the national immunization schedule.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConceptual Framework\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe Knowledge-Attitude-Practice (KAP) Model forms the foundation of the study\u0026rsquo;s conceptual framework, aiming to understand the relationships between awareness, beliefs, and actions towards cervical cancer prevention. Below is a detailed breakdown:\u003c/p\u003e\u003cp\u003e1.\u0026nbsp; \u0026nbsp;Knowledge: Knowledge represents an individual\u0026rsquo;s understanding of cervical cancer, including its causes (e.g., HPV), risk factors (e.g., multiple sexual partners), and preventive measures (e.g., vaccines and Pap smears). The study assesses this through questions like whether respondents have heard of HPV vaccines or understand how HPV is transmitted. While many respondents are aware of cervical cancer and its link to HPV, detailed understanding (e.g., the role of Pap smears) remains limited.\u003c/p\u003e\n\u003cp\u003e2.\u0026nbsp; \u0026nbsp;Attitude: Attitudes reflect respondents\u0026rsquo; beliefs, perceptions, and readiness to engage in preventive practices. In this study, attitudes were shaped by:\u003c/p\u003e\n\u003cp\u003ei.\u0026nbsp; \u0026nbsp;\u0026nbsp;Misconceptions, such as believing HPV vaccines are for sick individuals only.\u003c/p\u003e\n\u003cp\u003eii.\u0026nbsp; \u0026nbsp;Cultural beliefs, such as associating screening with immorality or stigmatization.\u003cbr\u003e\u0026nbsp;Negative attitudes often stem from partial or inaccurate information, emphasizing the need for trusted sources to reshape perceptions.\u003c/p\u003e\n\u003cp\u003e3.\u0026nbsp; \u0026nbsp;Practice: Practice refers to the actual engagement in preventive behaviours, such as HPV vaccination and cervical screening. Despite moderate knowledge levels, only a minority of respondents took preventive actions, pointing to significant barriers. Practices are often influenced by:\u003c/p\u003e\n\u003cp\u003ei.\u0026nbsp; \u0026nbsp;\u0026nbsp;Socioeconomic Barriers: High costs of vaccines and tests.\u003c/p\u003e\n\u003cp\u003eii.\u0026nbsp; \u0026nbsp;Healthcare Accessibility: Limited availability of services, especially in rural areas.\u003c/p\u003e\n\u003cp\u003eiii.\u0026nbsp;\u0026nbsp;Cultural Resistance: Reluctance to discuss or address sexual health openly.\u003c/p\u003e\n\u003cp\u003e4.\u0026nbsp; \u0026nbsp;Influencing Factors:\u003c/p\u003e\n\u003cp\u003ei.\u0026nbsp; \u0026nbsp;\u0026nbsp;Economic Barriers: Financial constraints make HPV vaccines and screenings unaffordable for many women.\u003c/p\u003e\n\u003cp\u003eii.\u0026nbsp; \u0026nbsp;Healthcare System Limitations: Inadequate integration of cervical cancer prevention into routine healthcare services exacerbates the problem.\u003c/p\u003e\n\u003cp\u003eiii.\u0026nbsp;\u0026nbsp;Cultural and Social Norms: Cultural stigmas around sexual health and preventive screenings discourage women from seeking help.\u003c/p\u003e\n\u003cp\u003eiv.\u0026nbsp;\u0026nbsp;Information Quality: The role of healthcare professionals and accurate media representation is vital in countering misconceptions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA descriptive cross-sectional study was employed to carry out the study. The study was conducted among female undergraduates in selected tertiary institutions in Osun State. The institutions were selected using a simple random sampling technique by balloting. The selected institutions are: Adeleke University Ede Osun state, Redeemer’s University Ede Osun State, and Osun State University, Oshogbo Osun State. 396 female participants were selected using a multistage sampling technique. This method was chosen to ensure a representative sample of reproductive-age women from both institutions, thereby enhancing the generalizability of the study findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in selected tertiary institutions in Osun State, Nigeria, specifically Adeleke University, Redeemer’s University, and Osun State University. Osun State, located in southwestern Nigeria, has a significant population of young women enrolled in higher education, providing an ideal setting to assess reproductive-age women’s knowledge, attitudes, and practices regarding cervical cancer prevention.\u003c/p\u003e\n\u003cp\u003eConducting this research in tertiary institutions is essential because college-aged women represent a critical demographic for cervical cancer prevention due to their increased likelihood of being sexually active and their potential openness to health information and interventions. However, studies have shown that, despite their accessibility to educational resources, young women in Nigeria often lack adequate knowledge about cervical cancer and its prevention.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBy focusing on institutions in Osun State, this study aims to highlight the gaps in knowledge, attitude, and preventive practices among a diverse group of educated young women. Findings from this research can inform targeted health education initiatives and policies in academic settings, helping to foster awareness and proactive health behaviours that may reduce cervical cancer risks in this vulnerable population.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTarget Population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe target population included female undergraduate attending various tertiary institutions in Osun State. However, the assessed population included Osun State University (Oshogbo Chapter), Redeemers University and Adeleke University Ede, Osun State.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and Exclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInclusion Criteria: Female undergraduates between the ages of 15-49 who were around during the period of conducting this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eExclusion Criteria: Potential respondents who declined consent to participate in the study were excluded. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample Technique and Sample Size Determination\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA probability based multistage sampling technique was adopted to select the institutions and the respondents. Three (3) tertiary institutions were chosen by balloting, a simple random sampling technique to give institutions, both government owned and private owned in Osun State an equal chance of being chosen. Simple random sampling technique was adopted for the selection of faculties in each institution to give every faculty an equal chance of being chosen and two faculties from each institution were chosen by balloting.\u003c/p\u003e\n\u003cp\u003eQuestionnaires were distributed in the selected institutions in the respective faculties that were selected by balloting using proportionate sampling.\u0026nbsp;The sample size for this study was calculated using Taro Yamane (1967) formula to obtain the sufficient sample size. This sample size was used because we dealt with a finite population. The formula applied is given as\u003c/p\u003e\n\u003cp\u003en = N / (1 + N (e)\u003csup\u003e\u0026nbsp;2\u003c/sup\u003e)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhere n = Sample size, N = Total population under study, e = margin error and 1 = adjusted constant. Numbers were substituted for variables and a sample size of 377 was gotten 10% attrition rate was added and the total sample size was 415.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstrument for Data Collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study adopted a primary source of data collection. The instrument was a Semi-structured questionnaire, designed to include both open-ended and close-ended questions. The questionnaire was categorized into four sections with 47 total variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe information obtained were collated, examined for completion and was imputed into IBM SPSS version 21 for analysis. Percentages, frequencies, tables and charts were used to analyse and present data related to objectives and socio-demographic characteristics.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTo assess the level of knowledge, knowledge questions were scaled and scored and categorized to the best midline such that 0-11(first half) was coded as poor knowledge and 12-23 (second half) as good knowledge, to assess the level of attitude, attitude questions were scaled and scored and categorized to the best midline such that 0-5(first half) was coded as negative attitude and 6-11(second half) as positive attitude.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll right responses were coded as 1 and all wrong responses were coded as 0. Chi-square was used to test the association between the knowledge and practice of cervical cancer prevention as well as attitude and practice of cervical cancer prevention among reproductive age women in the selected institutions in Osun state. The level of significance was set at 0.05. Decision rule is that at p value less or equal to 0.05, hypothesis was considered statistically significant and greater than 0.05 was considered statistically not significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eValidity and Reliability of Instrument\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe question undergone face and content validity by our research supervisor, who scrutinized the items and ensured they captured the true picture of variables under the study. Her comment and observation were used to revisit the questionnaire before the final draft. \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eReliability was determined through a pre-test carried out among 42 female students in federal polytechnic Ede, Osun State.\u003c/p\u003e\n\u003cp\u003eReliability test for level of knowledge variables was conducted using Cronbach’s alpha with intra-class coefficient value of 0.72.\u003c/p\u003e\n\u003cp\u003eReliability test for level of attitude variables was conducted using Cronbach’s alpha with intra-class coefficient value of 0.76\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the research and ethics committee of Adeleke University and letters of permission was retrieved and submitted to the registrars of the selected tertiary institutions. Only willing individuals were interviewed, informed consent was obtained before interviewing respondents and they were treated with respect. Confidentiality of all respondents and information obtained in the course of this survey was ensured and maintained. \u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAttitude of Respondents on Cervical Cancer Prevention \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;(n=396)\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"630\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003es/n\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eHuman papilloma virus vaccine is meant for unhealthy individuals only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e18.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e19.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eCervical cancer screening is meant for only those who are sick\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e168\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e10.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e8.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e25.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e42.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eHaving multiple sexual partners can increase the risk of cervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e39.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e39.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e14.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eHPV is transmitted through sexual intercourse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e35.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e35.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e23.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eHPV can increase the risk of cervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e35.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e28.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e18.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e14.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eEarly marriage onset is a risk to cervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e19.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eCervical cancer is a major health problem for women\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e41.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eEarly diagnosis of premalignant lesions is good for treatment outcome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e46.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e31.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e15.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eCervical cancer is preventable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e47.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e29.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e15.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eCervical cancer is curable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e137\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e34.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e29.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e12.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e11.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 325px;\"\u003e\n \u003cp\u003eEarly screening can help detect the onset of premalignant lesions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e42.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssociation between Knowledge of Reproductive Age Women and Prevention of Cervical Cancer\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge on Cervical Cancer prevention\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDecision\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLow\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHigh\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 141px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevention of cervical cancer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e.121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot sig.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssociation between Attitude of Reproductive Age Women and Prevention of Cervical Cancer\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAttitude towards cervical cancer prevention\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDecision\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevention of cervical cancer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGood\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e.905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot sig.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePoor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u003cstrong\u003eSocio-Demographic Characteristics of Participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe mean age of respondents was 25.305\u0026plusmn;8.195. 79.0% were Christians, 82.1% were Yoruba. 97.5% were full time students, 48.5% were from 100 level, and 93.9% were single. Overall Results revealed that 52.0% had good knowledge of cervical cancer prevention. 77.0% had bad practice towards cervical cancer prevention, and\u0026nbsp;52.0% had negative attitude towards cervical cancer prevention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge on Cervical Cancer Prevention\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study highlights that only 52% of the study respondents have adequate knowledge of cervical cancer prevention, while 48% lack sufficient awareness. This indicates a substantial gap in knowledge despite the presence of health information sources, pointing to missed opportunities for education and awareness-building among this population. This result is consistent with findings from Adebayo et al. (2021)\u003csup\u003e[14]\u003c/sup\u003e, who noted similar knowledge levels (60.6%) among antenatal attendees in Ibadan, and Ekwonwa et al. (2017)\u003csup\u003e[15]\u003c/sup\u003e, where knowledge levels were even higher (72.8%) among reproductive-age women in Ede South. This pattern suggests that women within healthcare settings, like antenatal clinics, may have more access to cervical cancer information than those in other environments.\u003c/p\u003e\n\u003cp\u003eHowever, the results contrast with Ogbonna (2017)\u003csup\u003e[16]\u003c/sup\u003e, where less than half of the respondents displayed adequate knowledge. This discrepancy may reflect differences in education access, geographic or socioeconomic backgrounds, and healthcare exposure across study populations. Although most respondents in the article\u0026rsquo;s study were aware of the HPV vaccine and the benefits of early screening, many were unfamiliar with the terminology, such as what a Pap smear is. This detail signals potential deficiencies in the clarity and comprehensiveness of health messaging, where specific terms and procedural information may not be fully explained or emphasized, possibly leading to misunderstandings about preventive measures.\u003c/p\u003e\n\u003cp\u003eHealth workers and media emerged as the most common sources of information for the study respondents, consistent with findings by Duru et al. (2015)\u003csup\u003e[17]\u003c/sup\u003e and Ilika (2016)\u003csup\u003e[18]\u003c/sup\u003e. This reliance on health workers underscores the critical role healthcare professionals play in disseminating accurate health information. However, the mass media\u0026rsquo;s significant influence highlights both an opportunity and a challenge: while media can reach large audiences, it can also convey unfiltered or incorrect information. This risk may partially explain why knowledge and attitudes toward cervical cancer prevention remain inconsistent or limited.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttitude Towards Cervical Cancer Prevention\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhile knowledge is moderate, attitudes toward cervical cancer prevention were notably negative in over half (52%) of the respondents. This outcome contrasts with Mullatu et al. (2017)\u003csup\u003e[19]\u003c/sup\u003e, where a majority of female students at Mizan Tepi University held positive attitudes. The article attributes this difference to unfiltered information, particularly from non-healthcare sources, that may foster misconceptions. This finding reflects a broader issue where partial or inaccurate information can hinder preventive attitudes, as also noted by Sajid et al. (2019)\u003csup\u003e[20]\u003c/sup\u003e, who reported that over half of their respondents\u0026rsquo; believed screening was unnecessary without symptoms.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThis underscores the need for accurate, trusted health information to shift attitudes positively. Negative attitudes among respondents could contribute to low engagement in preventive behaviours, as individuals are less likely to seek services they do not prioritize or fully understand.\u003c/p\u003e\n\u003cp\u003eThe practice of preventive behaviours like screening and HPV vaccination is markedly low among the respondents, with 77% showing poor preventive practices. Despite having some knowledge, most respondents have not acted on it, as evidenced by\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e74.5% who never underwent HPV testing\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e72.5% who never received the HPV vaccine\u003cstrong\u003e,\u003c/strong\u003e and\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e58.6% who never participated in cervical cancer screening\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eThis gap between knowledge and practice is consistent with other studies, such as Nowomuhangi (2019)\u003csup\u003e[21]\u003c/sup\u003e, where only half of the first-year nursing students had undergone screening, and Rahmat, A. et al. (2021)\u003csup\u003e[22]\u003c/sup\u003e, which found a 30% screening uptake among respondents. This pattern suggests a systemic issue across Africa, where knowledge is present but does not translate into action due to barriers like access to healthcare, affordability of preventive measures, cultural beliefs, and potentially low risk perception.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssociation between Knowledge and Attitude of Reproductive Age Women and Prevention of Cervical Cancer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe chi-squares results showed that there is no significant association between knowledge and practices of cervical cancer screening and vaccine intake towards cervical cancer prevention (\u0026chi;\u003csup\u003e2\u003c/sup\u003e= 2.537\u003csup\u003ea\u003c/sup\u003e; p-value= .121; df =1), attitude and practices of cervical cancer prevention (\u0026chi;\u003csup\u003e2\u003c/sup\u003e= .025\u003csup\u003ea\u003c/sup\u003e; p-value= .905; df =1). This result implies that, attitude is not a predictor as regards cervical cancer prevention and the knowledge demonstrated by the respondents do not have effect on the practice of cervical cancer prevention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplications for Assessment of Knowledge and Attitude\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings underscore a critical need for enhanced education and practical interventions to bridge the knowledge-attitude-practice gap. Health programs must focus on clear communication, addressing misconceptions, and creating accessible channels for screening and vaccination. Additionally, policy measures that subsidize or integrate HPV vaccines and screenings into regular health services could significantly improve preventive practice uptake. These actions would address the practical challenges that hinder behaviour change, helping align knowledge and attitude with consistent preventive practices.\u003c/p\u003e\n\u003cp\u003eIn summary, while this study reveals that awareness is present among reproductive-age women, barriers rooted in information quality, cultural context, and systemic healthcare access issues prevent this knowledge from translating into preventive actions. These insights indicate a need for tailored health interventions that directly address the structural and cultural barriers to cervical cancer prevention in Nigeria and similar settings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study revealed significant gaps in knowledge, attitudes, and practices toward cervical cancer prevention among reproductive-age women in selected tertiary institutions in Osun State. Although 52% demonstrated adequate knowledge of cervical cancer prevention, this awareness did not translate into preventive actions, with 77% of the respondents reporting poor practices.\u003c/p\u003e\n\u003cp\u003eFurthermore, 52% of the participants exhibited a negative attitude toward cervical cancer prevention, suggesting that awareness alone is insufficient to encourage proactive health behaviours. Major sources of information included health workers and media, yet the study identified that misconceptions from non-health sources may negatively impact preventive attitudes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThese findings suggest that increasing knowledge alone may not lead to improved health behaviours without addressing underlying cultural, social, and systemic barriers. Misconceptions about cervical cancer screening and the HPV vaccine, fuelled by inadequate health information or partial understanding, can result in negative attitudes that discourage preventive actions. The observed disconnect between knowledge and practice calls for more targeted health education initiatives that address cultural stigmas, provide accurate information, and foster positive attitudes toward cervical cancer prevention.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThese findings underscore a complex interplay between knowledge, cultural beliefs, attitudes, and systemic barriers, which collectively hinder the adoption of preventive measures. By understanding that knowledge and attitude gaps are deeply rooted in larger social and informational contexts, future interventions can be designed to support behaviour change more effectively.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo address the gaps identified in this study, the following recommendations are proposed:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFor Practice and Policy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1.\u0026nbsp; \u0026nbsp;Integrate Cervical Cancer Prevention into Institutional Health Programs: Establish routine health education sessions in tertiary institutions, focusing on cervical cancer awareness and the importance of preventive practices like screening and HPV vaccination. This can ensure sustained exposure to accurate information within academic environments.\u003c/p\u003e\n\u003cp\u003e2.\u0026nbsp; \u0026nbsp;Subsidize HPV Vaccination and Screening Costs: Advocate for policy interventions that make HPV vaccination and cervical cancer screenings more affordable and accessible. Including these services in Nigeria\u0026rsquo;s public health agenda can help overcome financial barriers that deter preventive practices.\u003c/p\u003e\n\u003cp\u003e3.\u0026nbsp; \u0026nbsp;Collaborate with Trusted Community Leaders and Healthcare Professionals: Partner with local healthcare providers and community influencers to build trust and improve the credibility of cervical cancer education, making it easier to address and overcome cultural and social barriers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFor Health Education and Public Awareness\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1.\u0026nbsp; \u0026nbsp;Enhance Clarity and Accessibility of Health Information: Develop clear and accessible educational materials that demystify cervical cancer prevention terminology, such as explaining Pap smear testing. This will help bridge knowledge gaps, particularly among those unfamiliar with medical terminology.\u003c/p\u003e\n\u003cp\u003e2.\u0026nbsp; \u0026nbsp;Use Media to Promote Positive Health Behaviours: Leverage mass media and social media platforms to disseminate reliable health information and debunk misconceptions. Campaigns can be tailored to target young women in tertiary institutions, using relatable messaging and testimonials to foster positive attitudes toward preventive actions.\u003c/p\u003e\n\u003cp\u003e3.\u0026nbsp; \u0026nbsp;Implement Interactive Workshops and Peer Education Programs: Host interactive sessions, such as workshops and peer-led education programs, where women can openly discuss misconceptions, address cultural beliefs, and learn about cervical cancer prevention in an engaging and supportive environment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFor Future Research and Development\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e1.\u0026nbsp; \u0026nbsp;Explore Additional Factors Affecting Behaviour Change: Conduct further studies to examine unaddressed variables like motivation, healthcare access, and the impact of socioeconomic status on preventive behaviour. These insights can inform more tailored interventions that effectively convert knowledge and attitude into action.\u003c/p\u003e\n\u003cp\u003e2.\u0026nbsp; \u0026nbsp;Evaluate Health Education Strategies: Implement pilot programs testing different health education approaches and monitor their effectiveness in changing knowledge, attitudes, and practices. This data can help optimize cervical cancer awareness programs and identify the most impactful communication strategies.\u003c/p\u003e\n\u003cp\u003eBy implementing these recommendations, public health stakeholders and educational institutions can create a supportive environment for cervical cancer prevention, ensuring that knowledge and positive attitudes translate into tangible preventive actions among women in Nigeria and similar contexts.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eETHICS APPROVAL AND CONSENT TO PARTICIPATE\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eEthical approval for this study was obtained from the research and ethics committee of Adeleke University and letters of permission was retrieved and submitted to the registrars of the selected tertiary institutions. Only willing individuals were interviewed, informed consent was obtained before interviewing respondents and they were treated with respect. Confidentiality of all respondents and information obtained in the course of this survey was ensured and maintained.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eCONSENT FOR PUBLICATION\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eAll participants provided an informed consent for the anonymised data to be published as part of this study.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003ch2\u003eCOMPETING INTERESTS\u003c/h2\u003e\u003cp\u003eAll authors declare that there is no competing interest.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003ch2\u003eFUNDING INFORMATION\u003c/h2\u003e\u003cp\u003eNo funding received for the study.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAll authors contributed to the research\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eAll authors are acknowledged\u003c/p\u003e\u003ch2\u003eAVAILABILITY OF DATA AND MATERIALS\u003c/h2\u003e\u003cp\u003eThe datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAmerican society of clinical oncology. (2020). Cervical cancer Diagnosis and Stages. Knowledge Conquers Cancer\u003c/li\u003e\n\u003cli\u003eSaad A., Kabiru S., Suleiman H., Rukaiya A. (2013). Knowledge, Attitude and Practice of Cervical Cancer Screening among Market Women in Zaria, Nigeria. Nigeria medical Journal vol.54 \u003c/li\u003e\n\u003cli\u003eAmine, C., Sanaa EL M., Nabil, I., Zakia, C., Jamal, B., Chakib, N., Amine EL H., Yahya C. and Noureddine, B. (2016). Evaluation of the Cost of Cervical Cancer at the National Institute of Oncology, Rabat. Pan African Medical Journal. Vol. 23\u003c/li\u003e\n\u003cli\u003eGlobocan. (2012). Cervical Cancer: Estimated Incidence, Mortality and Prevalence Worldwide in 2012. \u003c/li\u003e\n\u003cli\u003eInternational Agency for Research on Cancer (IARC) (2012).\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. (2015). Cervical Cancer.\u003c/li\u003e\n\u003cli\u003eAjibola, I., Olowookere, S., Fagbemi, A. and Ogunlaja, O. (2016). Determinants of cervical cancer screening uptake among women in Ilorin, North Central Nigeria: a community-based study. Journal of cancer epidemiology. Vol. 2016, article ID 6469240, 8 pages.\u003c/li\u003e\n\u003cli\u003eScott, A M., Venetia, Q., Johannes, B., Hester, M. and Johannes A. (2017). Disease Burden of Human Papillomavirus Infection in the Netherlands. The Gap between Females and Males is Diminishing.\u003c/li\u003e\n\u003cli\u003eMusa, J., Nankat, J., Achenbach, C., Shambe, H., Taiwo, O., Mandong, B., Daru, P., Murphy, R. and Sagay, S. (2016). Cervical cancer survival in a resource-limited setting-North Central Nigeria. Infect. Agents Canc., vol.11 (1) (2016), p. 15 \u003c/li\u003e\n\u003cli\u003eKumar, H., and Tanya, S. (2014). A Study on Knowledge and Screening for Cervical Cancer among Women in Mangalore City. Ann Med Health Sci Res.\u003c/li\u003e\n\u003cli\u003eSaslow, D., Solomon, D. and Lawson, H. (2012) American cancer society, American society for colposcopy and cervical pathology, and American society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer. A Cancer Journal for Clinicians, vol. 62, no. 3, pp. 147\u0026ndash;172.\u003c/li\u003e\n\u003cli\u003eWHO. (2014). Comprehensive Cervical Cancer Control: A Guide to Essential Practice.\u003c/li\u003e\n\u003cli\u003eOkonufua, F. (2007). HPV Vaccine and Prevention of Cervical Cancer in Africa. AFR J Reprod Health.\u003c/li\u003e\n\u003cli\u003eAdebayo M. and Oluwasomidoyin O. (2021). The Determinants of Knowledge of Cervical Cancer, Attitude towards Screening and Practice of Cervical Cancer Prevention amongst Antenatal Attendees in Ibadan, Southwest Nigeria.\u003c/li\u003e\n\u003cli\u003eEkwonwa E., Olariike K., Abayomi O. and Ugushida O. (2020). Awareness, Knowledge and Uptake of Cervical Cancer Screening among Women of Reproductive Age in Selected Wards in Ede South Local Government Area, Osun State. East African Scholars Journal of Medical Sciences.\u003c/li\u003e\n\u003cli\u003eOgbonna, F., and Med, A. (2017). Knowledge, Attitude, and Experience of Cervical Cancer and Screening among Sub-Saharan African Female Students in a UK University. National Library of Medicine 16(1): 18-23\u003c/li\u003e\n\u003cli\u003eDuru, C., Oluoha, R., Uwakwe, K., Diwe, K.C., Merenu, I., Emerole, C., and Iwu, C. (2015). Pattern of Pap Smear Test Results among Nigerian Women Attending Clinics in a Teaching Hospital. Int.J. Curr. Microbial. App. Sci, 4(4),986-998.\u003c/li\u003e\n\u003cli\u003eIIika, I., Gani O., and McFubara K. (2013). Cervical Cancer Screening among Female Undergraduates and Staff in the Niger Delta Region of Nigeria. Open Journal of Obstetrics and Gnecology. \u003c/li\u003e\n\u003cli\u003eMulatu, K., Ayalew, M., Melkam., and Mulugeta, T. (2017). Assessment of Knowledge, Attitude and Practice on Cervical Cancer Screening among Female Students of Mizan Tepi University, Ethiopia. Cancer Biol Ther Oncol.\u003c/li\u003e\n\u003cli\u003eSajid et al., (2019). Knowledge, Attitude and Practice towards cervical cancer screening among female health care professionals\u003c/li\u003e\n\u003cli\u003eNowomuhangi B. (2019). Knowledge, Attitude and Practice on Cervical Cancer and Screening among First Year Female Nursing Students of Kampala international university.\u003c/li\u003e\n\u003cli\u003eRahmat, A., Abimbola, O., and Olaide E. (2021). Predictors of Uptake of Cervical Cancer Screening among Nurses in Ogbomoso, Nigeria. African Journal of Midwifery and Women\u0026rsquo;s Health. Vol. 15\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables 1 and 2","content":"\u003cp\u003eTables 1 and 2 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Knowledge, Attitude, Women of Reproductive Age, Cervical Cancer Prevention","lastPublishedDoi":"10.21203/rs.3.rs-7177575/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7177575/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eCervical cancer remains a prevalent issue among reproductive-age women, with limited preventive practices observed in Nigeria. Cervical cancer is ranked as the second most common cancer among women aged 14 to 49 globally, including Nigeria. Developed countries have successfully reduced cervical cancer rates through effective screening and vaccination programs, which are underdeveloped and inefficient in Nigeria and many other developing nations.\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e\u003cp\u003eThis study aimed to assess the knowledge and attitudes of reproductive age women regarding cervical cancer prevention within selected tertiary institutions in Osun State, Nigeria.\u003c/p\u003e\u003ch2\u003eMethodology:\u003c/h2\u003e\u003cp\u003eA descriptive cross-sectional study was conducted involving 396 participants recruited through a multistage sampling. among reproductive age women in Osun State's selected tertiary institutions. Data was collected using a self-administered, questionnaire and analysed using SPSS version 21.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe average age of respondents was 25.305\u0026thinsp;\u0026plusmn;\u0026thinsp;8.195. 79.0% were Christians, and 21.0% were Muslims. While 52% had adequate knowledge, attitudes were generally negative, and only 23% engaged in preventive behaviours like HPV vaccination or screening. Statistical analysis showed no significant relationship between knowledge, attitude, and practice, suggesting that awareness alone does not influence behaviour.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThese findings highlight a need for targeted interventions that address cultural and organizational barriers to improve prevention uptake. Public health policies prioritizing HPV awareness and increased access to preventive services are recommended to reduce cervical cancer risks in this demographic.\u003c/p\u003e","manuscriptTitle":"Assessment of Knowledge and Attitude of Reproductive Age Women towards Cervical Cancer Prevention in Selected Tertiary Institutions in Osun State, Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-04 11:07:05","doi":"10.21203/rs.3.rs-7177575/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8184245d-7e43-4ec1-be01-2e5a605d4b0a","owner":[],"postedDate":"August 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-07T07:53:49+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-04 11:07:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7177575","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7177575","identity":"rs-7177575","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}