# Effect of Socioeconomic Status on Cervical Cancer Screening Behaviour Among Mothers of Adolescent Girls in Lagos, Nigeria: A Secondary Analysis of the mHealth-HPVac Study

## TL;DR

This study examines how socioeconomic status affects cervical cancer screening among mothers in Lagos, Nigeria, finding that screening rates are moderate and not strongly linked to income or education.

## Contribution

The study provides new insights into cervical cancer screening behavior in Nigeria, showing that socioeconomic factors do not strongly influence screening uptake.

## Key findings

- Approximately 51.7% of mothers reported prior cervical cancer screening.
- Age was significantly associated with screening, but income or education levels were not.
- Socioeconomic status was not independently linked to screening behavior.

## Abstract

Cervical cancer remains a preventable malignancy with high morbidity and mortality in low- and middle-income countries (LMICs). Screening uptake is suboptimal in sub-Saharan Africa, and the influence of socioeconomic status (SES) on screening behaviour among women remains insufficiently explored.

To determine the effect of SES on cervical cancer screening uptake among mothers of vaccine-eligible adolescent girls in Lagos, Nigeria.

This secondary analysis used baseline data from the mHealth-HPVac trial, including 180 sexually active mothers of unvaccinated girls aged 9–14 years. The primary outcome was self-reported cervical cancer screening within the previous 10 years. A multivariable logistic regression model was used to examine the association between SES and screening uptake, adjusting for age and tribe. Education and income were tested as an interaction term but excluded due to model instability.

Overall, 51.7% of participants reported prior cervical screening. Women who had been screened were significantly older than unscreened women (45.4±6.7 vs 41.7±7.2 years; p<0.001). Screening uptake did not differ significantly by marital status, education, employment, income class, tribe, or residential distance to screening facilities. In adjusted models, neither middle-income (adjusted odds ratio=1.72, 95% CI: 0.75–3.98) nor high-income status (adjusted odds ratio=1.22, 95% CI: 0.45–3.30) was associated with screening.

Cervical cancer screening uptake among mothers in Lagos is moderate, and SES was not independently associated with screening. Interventions should target structural or behavioural factors rather than focusing solely on economic disparities. Larger, adequately powered population-based studies are therefore needed to validate these findings and better delineate the socioeconomic gradients in screening behaviour among Nigerian women.