Cultural and traditional influences on cervical cancer screening uptake in Nigeria and other West African countries

BACKGROUND: The review examined cultural and traditional factors that hinder cervical cancer screening among women in Nigeria and similar low and middle income areas in Africa. Cervical cancer causes high mortality; however, early detection remains suboptimal, largely due to deeply rooted cultural beliefs and social norms. METHODS: This systematic review, guided by PRISMA 2020, examined these influences across Nigeria and comparable West African contexts, searching PubMed, Scopus, Web of Science, AJOL, and Google Scholar for studies published between January 1, 2000, and March 31, 2025. From 1,192 records, 27 studies were included (17 from Nigeria, 10 from Ghana, Senegal, Côte d'Ivoire, and Mali), comprising cross-sectional, qualitative, interventional, and retrospective designs focusing on women of 18 to 65 years and outcomes related to knowledge, beliefs, and screening behavior. RESULTS: Findings showed shared barriers across regions, including spiritual attributions of cancer as a curse or moral failing, religious prohibitions viewing screening as immodest, and family influences requiring spousal approval, leading to screening rates below 15% in Nigeria and 7 to 25% in other West African countries. Misconceptions that link cervical cancer to promiscuity or infertility actively deter screening uptake. In Nigeria, pronounced rural-urban disparities and strong elder influence exacerbate these barriers more than in other West African contexts. By contrast, Ghana places greater emphasis on modesty concerns, while Senegal exhibits heightened mistrust of Western medicine. Interventions that utilize female providers and local languages successfully increase screening uptake by 20 to 30% across both Nigerian and broader West African settings, although systemic weaknesses continue to limit long-term sustainability. Comparatively, the diverse ethnic norms in Nigeria actively amplify spiritual barriers, while studies from other West African countries show similar religious and family dynamics but demonstrate greater intervention success through integrated HIV care. CONCLUSIONS: Policymakers should focus on programs that respect local cultures and include community leaders and men. This approach will help reach the WHO's goal of 70% screening coverage by 2030 and save lives by using fair, area-specific plans.