Silent Barriers to Silent Killers: Women’s Lived Experiences of Breast and Cervical Cancer Care in Nigeria
Victoria Igbinomwanhia, Ibrahim Ambi, Temitope Olukomogbon, Elima Jedy-AgbaPURPOSE
Despite growing awareness of breast and cervical cancer in Nigeria, outcomes remain poor. This study explored how health system limitations, socio-cultural dynamics, and economic barriers shape women’s access to, trust in, and use of cancer screening and treatment services, with the aim of identifying pathways to improve early detection and equitable care.
METHODS
A qualitative study was conducted between July and September 2024 across the Federal Capital Territory, Nasarawa, and Rivers States. Data were collected through 60 in-depth interviews with community leaders, traditional healers, policymakers, religious leaders, and influential women, as well as 12 focus group discussions with community women. Participants were purposively selected to capture diverse perspectives on lived experiences of cancer awareness, screening behaviours, service access, and pathways to care. Interviews were conducted using semi-structured guides until saturation was reached, audio-recorded, transcribed verbatim, and analysed using inductive and deductive thematic analysis in Dedoose (v10.0).
RESULTS
Although willingness to undergo screening is increasing, major systemic barriers continue to limit uptake and continuity of care. Geographic inaccessibility, including long travel distances, few screening centers, and weak outreach systems, delayed early detection. Financial hardship further constrained access, as transportation, diagnostic, and treatment costs often forced women to postpone care or seek traditional and spiritual healing alternatives. Concerns about service quality also undermined trust. Participants reported poor provider attitudes, limited empathy, ineffective communication, and inadequate privacy. In Rivers State, fears of misdiagnosis and unclear test results further discouraged engagement with formal services. Cultural and gender norms, including stigma, fear of diagnosis, and discomfort with male healthcare providers, intersected with these systemic barriers and contributed to late presentation at advanced disease stages. Despite these challenges, women expressed readiness to participate in screening when services were accessible, affordable, and respectful. Community networks, faith-based groups, and NGOs emerged as important sources of mobilization and support.
CONCLUSION
Underutilization of cancer services in Nigeria is driven less by lack of awareness than by structural inequities within the health system. Improving outcomes requires decentralizing screening services, reducing financial barriers, strengthening empathetic provider training, and leveraging community-based platforms to deliver culturally responsive, people-centered cancer care.