PREVALENCE, RISK FACTORS, AND PREVENTION OF CERVICAL CANCER AMONG WOMEN OF REPRODUCTIVE AGE IN ABEOKUTA, OGUN STATE

CHAPTER ONE

INTRODUCTION

1. Background of the Study

The second most prevalent malignant tumor in women worldwide is cervical cancer, which poses a major threat to their health. It is a cancer arising from the cervix, in which the cells of the cervix become abnormal and start to grow uncontrollably, forming tumor. However, persistent infection of high-risk human papillomavirus (HPV) has been clarified to be the necessary cause of cervical cancer (Walboomers JM, Jacobs MV, Manos MM, et al, 2019). Approximately 90% of intraepithelial neoplasia is attributed to human papillomavirus (HPV) infection. Similarly, only certain types of HPV cause high grade intraepithelial lesions and cancer. The most common HPV are HPV-16, -18, -31, -33, -35, -39, -45, -51, -52, -56, and -58. Type 16 is the most common form of HPV found in invasive cancer and in CIN 2 and CIN 3 and HPV-18 is more specific than HPV-16 for invasive tumors- found lower (2%) in negative finding. In most women, the infection will clear in 9 to 15 months. The clear etiology accelerated the establishment and implementation of comprehensive prevention and control system of cervical cancer. In May 2018, the World Health Organization (WHO) issued a call for the elimination of cervical cancer globally, and more than 70 countries and international academic societies acted positively immediately (Herrero R, 2018). Thereafter, in November 17, 2020, WHO released the global strategy to accelerate the elimination of cervical cancer as a public health problem to light the road of cervical cancer prevention and control in future which mean that 194 countries promise together to eliminate cervical cancer for the first time.

Conceptually, Cancer is a broad term used to describe a class of diseases characterized by the uncontrolled and abnormal growth of cells, often forming tumors or masses. These cells have the ability to invade surrounding tissues and, in some cases, spread to other parts of the body through the bloodstream or lymphatic system. Cancer can affect virtually any tissue or organ in the body and may lead to severe health issues or death if not diagnosed and treated early. The development of cancer is a complex process involving genetic mutations, environmental factors, and interactions with the body's immune system. Similarly, it is a term used for malignant, autonomous and uncontrolled (and often rapid) growth (proliferation) of cells and tissues. Such growth forms tumors, which may invade the tissues around the cancer and cause new growth similar to the original in distant part of the body called metastases. However, cervical cancer forms in the tissue of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap test (a procedure in which cells are scraped from the cervix and looked at under a microscope.

In Nigeria, the incidence rate of cervical cancer was 25/100,000 as at 2005 and over 10,000 women die of cervical cancer annually usually in a painful, miserable and undignified manners (Franco EL, 2003).On the otherhand, the risk for developing cervical cancer is associated with early age of first intercourse, multiple sexual partners, smoking and infection with HPV, use of oral contraceptive for a longer period and occupation are the risk factors for the developing cervical cancer (Getachew E, 2015). In addition, unprotected intercourse, polygamy, low socioeconomic status, early marriages, limited education, early menstrual cycles, numerous pregnancies, smoking, co-infections, HPV infections, hormonal changes, and weakened immune systems.

Additionally, the prevalence of carcinogenic HPV infection is on the rise. Despite its high incidence, there are both primary and secondary preventive measures available, such as HPV immunization and treatments for preinvasive conditions. It has been reported that numerous women have never had a Pap smear in advanced countries, which accounts for 80% of all new cases (Sakshi, 2022). However, there has been calls for a coordinated effort to combat cervical cancer, involving various healthcare levels. Therefore, a survey will be conducted on prevalence, risk factors, and prevention of cervical cancer among women of reproductive age in Abeokuta, Ogun State

1. 1. Statement of the Problem

In many regions, including Western, Nigeria, cervical cancer remains a significant public health concern, particularly among women of reproductive age, with implications for both individual health and broader community well-being. However, limited access to healthcare, including Pap smears and HPV vaccinations, may contribute to a higher risk of cervical cancer. Also, lack of Regular Pap Smear Screenings: failure to undergo regular Pap smears or screenings for cervical abnormalities can result in late detection and treatment, increasing the risk of cervical cancer.

Additionally, some studies suggest that infection with the bacterium Chlamydia trachomatis may increase the risk of cervical cancer (May, 2009). Having multiple sexual partners, or having a partner with multiple sexual partners, increases the risk of HPV transmission. Furthermore, conditions or medications that weaken the immune system, such as HIV/AIDS and immunosuppressive drugs, may increase susceptibility to HPV infection and hinder the body's ability to clear the virus. According to Crum (2009), smoking has been linked to an increased risk of cervical cancer. It may also reduce the effectiveness of the immune system in fighting HPV infections. It is in the light of these that the study seeks to investigate the prevalence, risk factors, and prevention of cervical cancer among women of reproductive age in Abeokuta, Ogun State.

1.3 Objectives of the Study

The main purpose of this study is to investigate the prevalence, risk factors, and prevention of cervical cancer among women of reproductive age in Abeokuta, Ogun State. Specifically, the study will;

1. Determine the prevalence of cervical cancer among women of reproductive age in Abeokuta, Ogun State

1. Examine the level of awareness and knowledge about cervical cancer among women of reproductive age.

2. Assess the various risk factors associated with cervical cancer among women of reproductive age in Abeokuta, Ogun State

3. Evaluate the adoption of lifestyle modifications and other preventive measures against cervical cancer by women of reproductive age in Abeokuta, Ogun State

1.4 Research Questions

The following questions have been prepared for the study:

1. What is the extent of cervical cancer among women of reproductive age in Abeokuta, Ogun State?

2. What is the level of awareness and knowledge about cervical cancer among women of reproductive age?

3. What are the various risk factors associated with cervical cancer among women of reproductive age in Abeokuta, Ogun State?

4. What preventive measures are adopted by women to mitigate the risk of cervical cancer?

1.5 Significant of the Study

Prevalence, risk factors, and prevention of cervical cancer among women of reproductive age in Abeokuta, Ogun State. By delving into these aspects, this research aims to contribute valuable insights to healthcare practitioners, policymakers, and researchers, facilitating the development of targeted interventions and strategies to enhance the awareness and knowledge about cervical cancer, its risk factors and preventive measures.

Additionally, subsequent researchers will use it as a literature review. This means that other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regard to prevalence, risk factors, and prevention of cervical cancer among women of reproductive age in Abeokuta, Ogun State

1.6 Scope of the study

The scope of this study is boarded on prevalence, risk factors, and prevention of cervical cancer among women of reproductive age in Abeokuta, Ogun State

Theoretically, this study will determine the prevalence of cervical cancer, examine the level of awareness and knowledge about cervical cancer, assess the various risk factors associated with cervical cancer and evaluate the adoption of lifestyle modifications and other preventive measures against cervical cancer cervical cancer among women of reproductive age in Abeokuta, Ogun State. Geographically, the study will be delimited to women in Abeokuta, Ogun State, Nigeria.

1.7 Limitation of the study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed.

More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

1.8 Definition of Terms

Cancer: is a broad term used to describe a class of diseases characterized by the uncontrolled and abnormal growth of cells, often forming tumors or masses (American Cancer Society, 2021).