Participation in highly subsidized cervical cancer screening by women in Enugu, South-east Nigeria.

The current study was designed to evaluate the level of participation in a highly subsidized cervical screening in a resource-poor country. A total of 989 cervical smears performed on 932 women in Enugu, South-east Nigeria, over a 10-year period (January 1995-December 2004) was reviewed. The level of participation in cervical screening was very low, as <1% of the targeted women population participated. Almost 68% of the participants were referred for the screening and the majority (52.3%) were from lower social classes because the programme was highly subsidized. A total of 646 (65.3%) smears were normal. Of the abnormal smears, 193 (19.5%) had non-specific inflammatory changes, 136 (13.8%) showed dyskaryotic cells while 14 (1.4%) had neoplastic changes. A total of 57 (6.1%) women had more than one cervical cancer screening and they were characterised by increasing age, up to 59 years, higher social classes and contraceptive users in lower social classes. To reverse the low level of participation in cervical cancer screening in developing countries, there is a need to provide highly subsidized (if not free) cervical cancer screening services, which must be followed by sustained cervical cancer awareness campaign.