Examining women’s perspectives regarding colposcopy in the cervical cancer screening program in rural Nigeria

Background: Cervical cancer remains a leading cause of morbidity and mortality among women in sub-Saharan Africa, with Nigeria bearing a significant burden. Despite the availability of screening programs, uptake remains low, particularly in rural areas. Understanding women’s perspectives on colposcopy as part of cervical cancer screening is crucial for program improvement. Objective: To examine women’s experiences, perceptions, and attitudes toward colposcopy cervical cancer screening programs in rural Nigeria, including knowledge of cervical cancer, screening procedure, and factors influencing screening uptake. Methods: In-depth interviews were conducted with 41 women aged 25–49 years in rural Nigeria. Participants included both HIV-positive and HIV-negative women who had either undergone cervical cancer screening or had not accessed services. Thematic analysis was employed to analyze interview transcripts. Results: Four major themes emerged: (1) Limited knowledge and awareness about cervical cancer and screening procedures; (2) Mixed experiences with screening processes, including inadequate pre-procedure education; (3) Multiple barriers to screening uptake including fear, stigma, transportation costs, and service delivery challenges; and (4) Recommendations for program improvement focusing on community awareness and service accessibility. Conclusion: Women’s perspectives reveal significant knowledge gaps, service delivery challenges, and structural barriers that impede optimal cervical cancer screening uptake. Comprehensive awareness campaigns, improved service delivery including better patient education about screening procedures, and community-based approaches are essential for enhancing program effectiveness in rural Nigeria. Keywords: cervical cancer, screening, colposcopy, women’s perspectives, barriers, rural Nigeria, HPV, visual inspection