title: The impact of community health educators on uptake of cervical and breast cancer prevention services in Nigeria.
abstract: OBJECTIVE
  To determine the impact of trained community health educators on the uptake of cervical and breast cancer screening, and HPV vaccination in rural communities in southeast Nigeria.
  
  
  METHODS
  A prospective population-based intervention study, with a before-and-after design, involved four randomly selected communities in southeast Nigeria from February 2014 to February 2016. Before the intervention, baseline data were collected on the uptake of cervical and breast cancer prevention services. The intervention was house-to-house education on cervical cancer and breast cancer prevention. Postintervention outcome measures included the uptake of cervical and breast cancer screening, and HPV vaccination within 6 months of intervention.
  
  
  RESULTS
  In total, 1327 women were enrolled. Before the intervention, 42 (3.2%) women had undergone cervical cancer screening; afterwards, 897 (67.6%) women had received screening (P<0.001). Clinical breast examination was performed for 59 (4.4%) women before and 897 (67.6%) after the intervention (P<0.001). Only 2 (0.9%) of 214 children eligible for HPV vaccination had received the vaccine before versus 71 (33.2%) after the intervention (P<0.001).
  
  
  CONCLUSIONS
  The use of community health educators for house-to-house cervical and breast cancer prevention education was associated with significant increases in the uptake of cervical cancer screening, clinical breast examination, and HPV vaccination.
authors.affiliation: Department of Obstetrics and Gynecology, University of Nigeria Nsukka, Nsukka, Nigeria.
authors.forename: Chibuike O
authors.initials: CO
authors.lastname: Chigbu
authors.affiliation: Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria.
authors.forename: Azubuike K
authors.initials: AK
authors.lastname: Onyebuchi
authors.affiliation: Department of Anaesthesia, University of Nigeria Nsukka, Nsukka, Nigeria.
authors.forename: Tonia C
authors.initials: TC
authors.lastname: Onyeka
authors.affiliation: Department of Obstetrics and Gynecology, Enugu State University Teaching Hospital, Enugu, Nigeria.
authors.forename: Boniface U
authors.initials: BU
authors.lastname: Odugu
authors.affiliation: Department of Obstetrics and Gynecology, University of Nigeria Nsukka, Nsukka, Nigeria.
authors.forename: Cyril C
authors.initials: CC
authors.lastname: Dim
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D003153:Community Health Services / Q000706:statistics & numerical data; D055088:Early Detection of Cancer; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data*; D040441:Health Educators / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D011446:Prospective Studies; D012424:Rural Population; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: Breast cancer; Cancer prevention; Cervical cancer; Health education