Islamic women in Ghana are staying away from cervical cancer screening not because they lack knowledge about the disease, but because of deep-seated fears, religious norms and culturally insensitive healthcare practices, and a new study from the Kwame Nkrumah University of Science and Technology is calling for urgent reform.

The study, published in the journal Health Science Reports in January 2026, surveyed 500 Islamic women in the Ayigya and Anloga communities of the Oforikrom Municipality in Kumasi, and found that despite more than half of the women having high knowledge about cervical cancer, actual screening participation was alarmingly low, with only 1.8% having ever been screened in their lifetime.

The finding upends a common assumption in public health circles that educating women about cervical cancer will drive them to screen.

The research found that women with high knowledge about the disease actually had lower odds of screening intentions compared to those with low knowledge, suggesting that knowledge alone is far from sufficient.

Instead, the study identified emotional anxiety, personal and religious norms, and the availability of culturally appropriate services as the most powerful determinants of whether a woman intended to get screened.

Women with high negative emotions about the screening process including anxiety about a possible cancer diagnosis and embarrassment about bodily exposure, had 18 times higher odds of screening intentions compared to those with lower emotional concerns.

The researchers interpreted this as evidence that women who were most anxious were also most alert to the need to screen but were ultimately held back by structural and cultural barriers rather than lack of will.

A particularly striking finding was the near-total absence of HPV vaccination, with 99.8% of participants unvaccinated, despite the availability of HPV vaccines in the country.

The study also found that the majority of participants had never heard of the Pap smear test, and none had undergone visual inspection with acetic acid, the most accessible screening method available in Ghana.

Lead researcher Abdul-Karim Abubakari and his colleagues at the University Hospital, in collaboration with Morehead State University in the United States, pointed to Ghana's lack of a national cervical cancer screening programme as a critical underlying factor, arguing that without a coordinated policy, screening services remain fragmented and opportunistic.

The researchers also highlighted the mismatch between Ghana's predominantly male healthcare workforce and the needs of Muslim women, who, according to Islamic norms, require same-sex providers during intimate examinations.

The study found that many participants indicated they would not attend screening sessions involving a male provider, a significant barrier in a health system where male gynaecological specialists dominate.

Religious sect also emerged as a significant variable. The majority of participants belonged to the Ahlus Sunna Wal-Jama'a sect, and women who reported high levels of religiosity were twice as likely to have higher screening intentions, a finding the researchers say should encourage health authorities to engage Islamic scholars and Imams as key partners in promoting screening.

"Islamic scholars and Imams in Islamic majority communities are encouraged to prioritise cervical cancer screening in their daily religious sermons, as preventive screening is an Islamic religious responsibility," the study recommended.

The researchers are also calling on the Ministry of Health and the Ghana Health Service to design and implement a national cervical cancer screening policy that directly addresses women's negative emotions and misconceptions about the process, and for annual cultural competency training for healthcare providers.

Cervical cancer remains the most prevalent cancer among Ghanaian women aged 15 to 44, with incidence and mortality rates well above the global average. Christians in the Ashanti Region have been found to undergo cervical cancer screening at rates nearly 18 times higher than their Muslim counterparts, a disparity the study's authors describe as both a health equity crisis and a policy failure.