Economic dependency and cancer screening behavior among women (30–49 years) in Nigeria: analysis of a national survey

Abstract

Economic dependency extends beyond limited decision-making power to encompass unemployment, restricted income generation, and residence in the poorest wealth strata. Women situated in these conditions may lack the financial capacity to afford screening, the resources to travel to health facilities, and the autonomy to prioritize preventive care over immediate household needs. Yet, empirical research in Nigeria has not adequately examined how this multidimensional economic dependency influences cancer screening behavior using nationally representative data. This study assesses the association between economic dependency and women’s cancer screening uptake in Nigeria. Data from the 2024 Nigerian Demographic and Health Survey were analyzed ( n = 17,941). Economic dependency was measured using a composite index incorporating employment status, household wealth, and financial decision-making autonomy. Weighted frequencies, percentages, and 95% confidence intervals were computed, and differences were assessed using design-based chi-square tests. Breast and cervical screening uptake were compared by economic dependency. Multivariable logistic regression models were computed in STATA 14. Statistical significance was set at p < 0.05. In 2024, only 7.9% [95%CI: 7.4–8.5] and 5% [95%CI: 4.6–5.5] of women (30–49 years) in Nigeria had undergone breast and cervical cancer screening, respectively. It was observed that 44.2% of the participants were economically dependent. The results revealed an inverse association between economic dependency and cancer screening behavior. Economically dependent women appeared to have lower odds of undergoing breast [COR: 0.51; 95%CI: 0.46–0.58] and cervical cancer screening [COR: 0.53; 95%CI: 0.45–0.61]. After adjusting for covariates, there was still a statistically significant association between economic dependency and breast [AOR: 0.83; 95%CI: 0.73–0.94] and cervical cancer screening [AOR: 0.84; 95%CI: 0.71–0.99]. The study has suggested that economic dependency is an important barrier to breast and cervical cancer screening among women in Nigeria. Policies that reduce the financial and structural barriers associated with dependence, particularly through improved financial protection within screening services, may help improve screening uptake.