Prevalence and determinants of cervical cancer screening among women aged 30–49 years in Nigeria: A population-based cross-sectional study

Cervical cancer poses a major global health challenge, particularly impacting women.Although largely preventable through regular screening, uptake remains suboptimal in Nigeria due to multiple access barriers. Guided by Andersen's Behavioural Model of Health Services Use - which posits that health service utilisation is influenced by predisposing, enabling, and need factors - this study assessed the prevalence and determinants of cervical cancer screening among women aged 30-49 years in Nigeria. We analysed secondary data from the 2023-24 Nigeria Demographic and Health Survey, including a weighted sample of 17,649 women aged 30-49 years. Analyses accounted for the complex survey design and were conducted using Stata version 18. Multivariable logistic regression was used to identify determinants of cervical cancer screening, with statistical significance set at p < 0.05. Cervical cancer screening among women aged 30-49 years in Nigeria was 5% (95% CI = 4.6, 5.5), ranging from 3.3% in the North East and 10.8% in the South West. Consistent with Andersen's model, predisposing factors such as older age and higher education (AOR = 2.37; 95% CI: 1.58-3.57) were associated with increased screening. Enabling factors - including higher wealth quintile (AOR = 1.47; 95% CI: 1.03-2.14), health insurance coverage, recent health facility visit, prior breast cancer examination (AOR = 4.22; 95% CI: 2.70-5.91) and regular mass media exposure - significantly improved uptake. The Need factors - HIV-positive status (AOR = 4.34; 95% CI: 2.34-8.05) was a strong predictor. Conversely, higher parity (≥3 children) and residence in certain regions (North Central and South East) were associated with lower odds of screening. Cervical cancer screening prevalence among Nigerian women remains very low. Findings, highlight the critical role of socioeconomic access, health system contact, and perceived need in shaping screening behaviour. Interventions should prioritise reducing financial and geographical barriers, strengthening routine health system touchpoints, and enhancing risk perception through targeted health education to improve equitable screening uptake.