Developing and Testing a Community-Based Participatory Cancer Screening Model for Rural Communities in Taraba State

Background: Cancer screening uptake in rural Nigeria is critically low, and existing facility-based screening models fail to reach the most marginalised populations. A community-based participatory model designed with and for rural communities in the North East geopolitical zone offers a theoretically and empirically grounded alternative. This study develops and tests such a model in rural Taraba State. Methodology: A community-based participatory research design engaged community members, traditional leaders, female health volunteers, and primary care practitioners in co-designing a cancer screening model across three phases. Phase one was qualitative co-design with 40 community stakeholders. Phase two piloted the model in eight rural communities. Phase three evaluated model effectiveness using a non-randomised controlled design comparing 300 intervention and 300 control community women for cervical and breast cancer screening uptake. Results: Screening uptake in intervention communities was significantly higher than controls for both cervical and breast cancer. Community female health volunteers as trusted screening mobilisers were the highest-rated enabler. The model was acceptable to traditional and religious leaders when incorporated in co-design. Conclusion: The community-based participatory cancer screening model developed in Taraba State demonstrates efficacy and cultural acceptability and provides an original evidence base for scaling community-delivered cancer screening in rural Northern Nigeria. Keywords: cancer screening, community-based participatory, rural communities, Taraba State, cervical cancer