title: Non-uptake of colposcopy in a resource-poor setting.
abstract: OBJECTIVE
  To determine the rate of acceptance/refusal of colposcopy and the reasons for refusal by women referred for the procedure in southeast Nigeria.
  
  
  METHODS
  An audit was performed of the computerized database for all women referred for colposcopy at the University of Nigeria Teaching Hospital, Enugu, from August 1, 2009, to July 31, 2010. The characteristics of those who accepted colposcopy were compared with those who refused the procedure. An interviewer-administered questionnaire was used to assess reasons for refusal and the subsequent treatment chosen.
  
  
  RESULTS
  During the study period, 154 women were referred for colposcopy: 103 (66.9%) accepted and 51 (33.1%) refused. Those who refused were younger and tended to be nulliparous (P=0.029 and P=0.004, respectively). The most common reasons for refusal were fears of possible diagnosis of cervical cancer and compromise of future fertility. Most women who refused resorted to spiritual healing.
  
  
  CONCLUSIONS
  The rate of refusal of colposcopy in southeast Nigeria was high, indicating an urgent need for appropriate remedial measures instituted through intensive education of women regarding cervical cancer and its prevention. Targeted counseling should be initiated early as part of prescreening counseling.
authors.affiliation: Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Enugu, Nigeria. chchigbu@yahoo.com
authors.forename: Chibuike O
authors.initials: CO
authors.lastname: Chigbu
authors.forename: Uzo U
authors.initials: UU
authors.lastname: Aniebue
mesh_terms: D000328:Adult; D000367:Age Factors; D003127:Colposcopy / Q000379:methods / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005239:Fear; D005260:Female; D006801:Humans; D008875:Middle Aged; D009549:Nigeria; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D026443:Spiritual Therapies / Q000379:methods; D011795:Surveys and Questionnaires; D016312:Treatment Refusal / Q000523:psychology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*