Exploring women's knowledge and their perception of risk of uterine cancer in Lagos, Nigeria: a multi-facility based cross-sectional study

Introduction: The absence of an established screening strategy to effectively detect uterine cancer (UC) at its early stage and the favourable outcome associated with early disease has put a premium on the need for increased public knowledge of UC to raise awareness about the risk of the disease and encourage the prompt presentation of suspicious symptoms and early diagnosis to improve health outcomes and survival. Objectives: We, therefore, sought to explore the knowledge of UC symptoms, risk factors, risk-reducing health measures and their perceived risk of developing the disease among women in Lagos, Nigeria. Methods: The study was a descriptive cross-sectional study conducted among 555 community women who attended government-owned secondary health facilities in three randomly selected Local Government Areas in Lagos, Nigeria. Information on sociodemographic and reproductive characteristics, awareness and knowledge about UC, its symptoms, risk factors, risk-reducing health measure, and perception of the risk of having UC were collected using an interviewer-administered questionnaire to assess women's knowledge and their perception of risk of UC. Data analysis was done using SPSS version 23. Results: Though 58.4% of the respondents were aware of UC, only 27.4%, 34.9% and 39.3% had good knowledge of the risk factors, symptoms and risk-reducing health measures of UC, respectively. The overall knowledge about UC was low with 25.0% having good knowledge about UC, while only 11.2% believed they may be at risk of developing UC. Being 25 years and below in age [adjusted odd ratio (AOR) = 2.55, CI = 1.36-4.77, p = 0.003], having at least a secondary education (AOR = 1.67, CI = 1.06-2.91, p = 0.046), being unmarried (AOR = 2.69, CI = 1.39-5.21, p = 0.003), a Christian (AOR = 1.89, CI = 1.09-3.27, p = 0.023), knowing someone with UC (AOR = 6.62, CI = 3.12-14.01, p < 0.001) and discussion with a doctor about UC (AOR = 5.72, CI = 3.43-9.53, p < 0.001) significantly predicted good knowledge of UC. Similarly, being 25 years and below in age (AOR = 2.49, CI = 1.20-5.17, p = 0.014), being a Muslim (AOR = 3.08, CI = 1.58-5.99, p = 0.001), knowing someone with UC (AOR = 3.11, CI = 1.27-7.57, p = 0.013) and having good knowledge of UC (COR = 5.88, CI = 2.80-12.35, p < 0.001) significantly influenced perception of the risk of developing UC. Conclusion: Women's knowledge of UC and their perceived risk of developing the disease is very low in Lagos, Nigeria. Age, education, marital status, religion, knowing someone with UC and discussion with a doctor significantly influenced their knowledge and perceived susceptibility to the disease. There is a need for strategic educational interventions to address the knowledge gaps to improve health outcomes.