Cervical cancer remains a leading cause of cancer morbidity and mortality among women in Nigeria, despite the availability of effective preventive interventions such as Pap smear screening and human papillomavirus vaccination. Empirical evidence increasingly suggests that disparities in prevention uptake are shaped less by individual attitudes alone and more by structural factors that influence access to information, services, and decision-making capacity. Drawing on data from a cross-sectional study of 402 women attending primary health centres in Nnewi-North Local Government Area, Anambra State, this paper examines educational attainment as a key determinant of knowledge, attitudes, and preventive behaviour related to cervical cancer. Education emerged as the most consistent and statistically significant predictor of awareness of cervical cancer, understanding of Pap smear screening, knowledge of HPV vaccination, and willingness to recommend vaccination. In contrast, age, parity, sexual activity, and marital status showed limited or no association with preventive behaviours. The findings highlight education not merely as an individual attribute, but as a structural enabler of health literacy, agency, and engagement with preventive services. The paper argues that cervical cancer prevention strategies in Nigeria must move beyond awareness campaigns alone and adopt education-sensitive approaches that address entrenched inequalities in access to information and care. Integrating cervical cancer prevention into routine primary healthcare, alongside targeted community education for women with lower educational attainment, is essential for reducing persistent gaps between awareness and practice.

Cervical cancer, education, Pap smear, HPV vaccination, health inequality, Nigeria

Adejumo, O., Mamven, M., Edeki, I. R., Ajekwu, S. C., Bamikefa, T. A., Adedire, A., Eze, H. T., Oyedepo, D., Ngoka, S., Eromosele, G. T., Akinyosoye, G. O., Adebisi, O., & Odili, A. (2025). Facilitators and barriers to the use of clinical practice guidelines among physicians in Nigeria: A cross-sectional study. BMJ Open 2025;15:e089535. https://doi.org/10.1136/bmjopen-2024-089535

Bhadra Vale, D., & Teixeira, J. C. (2023). Implementing plans for global elimination of cervical cancer. Nature Medicine, 29, 3004–3005. https://doi.org/10.1038/s41591-023-02577-0

Enebeli, M. O. (2025). Relationship between health literacy and level of education on health-related behaviours of the Nigerian population in Anambra State. African Journal of Health, Nursing and Midwifery, 8(3), 28–56. https://doi.org/10.52589/AJHNM-EYXRWWKR

Federal Ministry of Health. (2025). Statement by Nigeria: Global strategy on cervical cancer elimination. World Health Assembly. https://apps.who.int/gb/statements/WHA78/PDF/Nigeria-13.1b.pdf

Gomes, M., Provaggi, E., Pembe, A. B., Olaitan, A., & Gentry-Maharaj, A. (2025). Advancing cervical cancer prevention equity: Innovations in self-sampling and digital health technologies across healthcare settings. Diagnostics, 15(9), 1176. https://doi.org/10.3390/diagnostics15091176

ICO/IARC Information Centre on HPV and Cancer. (2023). Nigeria: Human papillomavirus and related cancers—Fact sheet 2023. https://hpvcentre.net/statistics/reports/NGA_FS.pdf

Ike, E. U., Nlemuwa, G. N., Gbadamosi, I. A., & Ndikom, C. M. (2025). Awareness and utilisation of cervical cancer screening among mothers attending antenatal and postnatal clinics at a state hospital in Nigeria. Reproductive Health. EMJ Reproductive Health. 2025;11[1]:63-72. https://doi.org/10.33590/emjreprohealth/MXLC6000

Irowa, O., Adeyeye, O. S., Ujah, O. I., Ogwuche, P. E., Otache, A. E., & Agulebe, C. J. (2025). Assessment of barriers to cervical cancer screening at primary health care centers in Makurdi, North-Central Nigeria: A mixed-methods study. BMC Cancer, 2025 Jul 1;25(1):1099. https://doi.org/10.1186/s12885-025-14494-1

Lawal, Q. O., Lawal, I. K., Carter, C. S., & Khan, S. (2023). Cervical cancer burden in Nigeria: Review of the current situation. Gynecology & Reproductive Health, 7(1), 1–5. https://doi.org/10.33425/2639-9342.1211

Ogah, P. O., Uguru, N., Okeke, C., Mohammed, N., Ogbe, O., Ashiver, W. G., & Aina, M. (2024). Primary health care in Nigeria: Best practices and quality of care. BMC Health Services Research, 24, 963. https://doi.org/10.1186/s12913-024-11406-0

Okolie, E. A., Beek, K., Patel, B., Ndikom, C. M., & Joshi, R. (2025). Cervical cancer prevention and control in Nigeria: Mapping and review of policies. Health Policy and Planning, 40(8), 931–942. https://doi.org/10.1093/heapol/czaf049

Olabanji, K. T. (2023). Interventions to improve health literacy in Nigeria: A systematic review of effectiveness and policy recommendations. The Nigerian Health Journal, 23(3), 707–716. https://doi.org/10.60787/tnhj.v23i3.714

Olamide, A. E., Jolayemi, E. T., & Atolagbe, J. E. (2025). Determinants of maternal health-seeking behavior among pregnant women in selected primary health care centers in Ado-Ekiti Local Government Area, Ekiti State. International Journal of Health and Pharmaceutical Research, 10(4), 89–103.

Olaoye, O., & Macdonald, S. (2024). A systematic review of interventions to promote human papillomavirus (HPV) vaccination in Africa. Public Health, 234, 47–57. https://doi.org/10.1016/j.puhe.2024.05.015

Shin, M. B., Liu, G., Mugo, N., Garcia, P. J., Rao, D. W., Broshkevitch, C. J., Eckert, L. O., Pinder, L. F., & Barnabas, R. V. (2021). A framework for cervical cancer elimination in low- and middle-income countries: A scoping review and roadmap for interventions and research priorities. Frontiers in Public Health, 9, 670032. https://doi.org/10.3389/fpubh.2021.670032

Tin, K. N., Ngamjarus, C., Rattanakanokchai, S., Sothornwit, J., Aue-Aungkul, A., Paing, A. K., Pattanittum, P., & Jampathong, N. (2023). Interventions to increase the uptake of cervical cancer screening in low- and middle-income countries: A systematic review and meta-analysis. BMC Women’s Health, 23, 120. https://doi.org/10.1186/s12905-023-02265-8

Torres, O., Dehn Lunn, A., & Ford, J. (2023). Addressing inequalities in cervical cancer screening: Evidence brief. Health Equity Evidence Centre. https://www.sneeics.org.uk/wp-content/uploads/2024/01/Evidence-brief-cervical-screening-V1.pdf

Wright, K. O., Odugbemi, B. A., Popoola, B. F., Oduntan, K. O., Fagbemi, T., Abdurrazaq, H., Adepase, A., Oniyire, D., Lajide, O., Ogboye, I., & Mustafa, O. (2024). Implementation of primary health care in Lagos, Nigeria: An assessment of governance and service availability. Journal of Community Medicine and Primary Health Care, 36(2), 1–18. https://doi.org/10.4314/jcmphc.v36i2.1