Journal of Epidemiology and Public Health
ISSN: 3065-9078 | DOI: 10.64030/3065-9078
Ogechi Gift Onyedi and Umunna Godson Nwagu
Endometrial cancer is an important women's health problem, and early recognition of suspicious symptoms may facilitate timely diagnosis. However, awareness alone may not guarantee access to appropriate diagnostic services. Evidence examining the relationship between endometrial cancer awareness, healthcare access and diagnostic delay among women at increased risk in Nigeria remains limited. This study examined the relationships between endometrial cancer awareness, healthcare access and diagnostic delay among high-risk women in Nigeria. A cross-sectional analytical study was conducted among 150 women drawn from a target population of 250 women in selected communities and a health facility in Enugu State, Nigeria. Participants were identified using predefined risk characteristics, including age ≥40 years, diabetes mellitus, hypertension, polycystic ovary syndrome, early menarche, late menopause, estrogen-only hormone replacement therapy, tamoxifen exposure and family history of relevant cancer. Data were collected using a researcher-developed Awareness–Access Paradox in Endometrial Cancer Questionnaire (AAPECQ). The instrument underwent face and content validation and demonstrated a split-half reliability coefficient of 0.82. Descriptive statistics and Pearson's product-moment correlation were used to analyse the data at a 0.05 significance level. Participants demonstrated relatively high awareness of endometrial cancer. Awareness of symptoms recorded the highest mean score (M = 3.68, SD = 0.59), followed by recognition of warning signs (M = 3.54, SD = 0.64), knowledge of risk factors (M = 3.42, SD = 0.71) and preventive measures (M = 3.36, SD = 0.73). Awareness was positively associated with healthcare access (r = 0.562, p < .001) and negatively associated with diagnostic delay (r = −0.487, p < .001). Healthcare access demonstrated the strongest association with diagnostic delay (r = −0.614, p < .001). Although awareness of endometrial cancer was relatively high, healthcare access demonstrated the strongest association with reported diagnostic delay. These findings suggest that awareness interventions should be complemented by measures that improve timely access to consultation, investigation, referral and diagnostic services. Integrated, risk-focused approaches may strengthen early detection of endometrial cancer among women in Nigeria.