Objective: This study aimed to evaluate reasons behind nonuptake of cervical cancer screening by women who are aware of cervical cancer screening in southeast Nigeria.

Method: Women attending gynecologic clinics of 3 health institutions in Enugu, Nigeria, were interviewed by means of a questionnaire to determine those who were aware of cervical cancer screening. The biodemographic characteristics and level of knowledge of cervical cancer screening of women who underwent a previous screen were compared with those of women who did not undergo a previous screen. Reasons for nonuptake of cervical cancer screening as well as potential reasons for undertaking cervical cancer screening were also extracted.

Results: A total of 3712 women were interviewed. Of these respondents, 2048 (55.2%) were aware of cervical cancer screening.

Only 19.0% of those who were aware of cervical cancer screening underwent a previous screen. Level of knowledge of cervical cancer prevention, university education, and age had a significant impact on the uptake of cervical cancer screening. Poor health-seeking behavior and fear of violation of privacy are the major reasons for nonuptake of cervical cancer screening. Potential reasons for uptake of cervical cancer screening include development of symptoms, adequate educative information, and physician's recommendation.

Conclusions: Women in southern Nigeria do not go for cervical cancer screening because of poor understanding of cervical cancer prevention, feeling of violation of the privacy of their genitals, and poor health-seeking behavior. There is a need to modify current policy approaches to cervical cancer prevention in Nigeria. Policies that will address the privacy violation fears and poor health-seeking behavior of the Nigerian woman as well improve the level of educative information on cervical cancer prevention need to be evolved.