Cervical cancer is the second most common cancer among Nigerian women, after breast cancer. Nigeria has one of the highest cervical cancer mortality rates in the world — approximately 26,000 women die from this disease every year, according to WHO data. To put this in context: that is more than 70 Nigerian women dying every single day from a cancer that is, with screening and early treatment, almost entirely preventable.
The diagnosis rate is equally alarming. Studies in Nigeria consistently show that more than 70% of cervical cancer cases are diagnosed at advanced stages (Stage III or IV), when treatment options are limited and outcomes are poor. Compare this to high-income countries where regular screening catches the majority of cases at pre-cancerous or early invasive stages — with near-100% treatment success rates.
The most important reason is simple: most Nigerian women have never been screened. Estimates from the Federal Ministry of Health suggest that fewer than 10% of Nigerian women of eligible age (25–65) have ever received any form of cervical cancer screening. For context, the WHO's target for elimination of cervical cancer as a public health problem requires 70% of women to be screened by age 35 and again by 45.
The reasons for this gap are multiple: low awareness of cervical cancer as a disease, widespread misconception that it primarily affects older women (it doesn't — HPV infection occurs in young sexually active women, and cervical changes develop over 10–15 years), cultural barriers to gynaecological examination, cost concerns, and limited availability of screening services at primary care level.
HPV vaccination — specifically with Gardasil 9 (protecting against types 6, 11, 16, 18, 31, 33, 45, 52, and 58) — prevents infection with the viral strains responsible for approximately 90% of cervical cancers. Nigeria introduced HPV vaccination into the national immunisation programme in 2023 for adolescent girls. Coverage is still low and the current vaccinated cohort will not reach screening age for another decade. The existing adult female population remains unprotected by vaccination and entirely dependent on screening.
Human papillomavirus (HPV) is not one virus — it is a family of over 200 related viruses. Most HPV infections are harmless and clear spontaneously within 1–2 years. The clinically important strains are divided into:
HPV 16 and 18 together account for approximately 70% of cervical cancers worldwide. HPV is transmitted through sexual contact — skin-to-skin, not just penetrative sex. Condom use reduces but does not eliminate transmission (the virus can be present on skin not covered by a condom).
VIA is recommended by the WHO as the primary screening method in resource-constrained settings. A trained provider applies dilute acetic acid (white vinegar) to the cervix and looks for acetowhite areas — cells that turn white, indicating HPV-associated changes. The result is immediate — the provider sees the result in the room within 60 seconds. Where eligible precancerous lesions are found, they can be treated immediately with cryotherapy or thermal ablation (a screen-and-treat approach). VIA is available at Mascot Healthcare, Akoka.
Cells scraped from the cervix are sent to a laboratory for microscopic examination. Results take 1–2 weeks. Abnormal cells are classified using the Bethesda system (ASCUS, LSIL, HSIL) and referred for colposcopy. Pap smear requires a functional cytology laboratory and a follow-up system — both available through Mascot Healthcare's laboratory network.
About the author: Dr. Chioma Ezenwachi is a Women's Health Physician at Mascot Healthcare, Akoka, Lagos. She is trained in VIA screening, Pap smear collection, and colposcopy counselling. This article is reviewed annually.
VIA and Pap smear available at Mascot Healthcare, Akoka. By appointment. 15 minutes. Could save your life.