This study was conducted in selected tertiary institutions in Osun State, Nigeria. Osun State is located in the South-West geopolitical zone and hosts a mix of public and private universities, contributing to a diverse academic environment. The selected institutions were Adeleke University (Ede), Redeemer’s University (Ede), and Osun State University (Osogbo Campus). These institutions were intentionally chosen to represent different ownership structures and socio-cultural student populations, allowing the findings to reflect variations in exposure to health information and access to healthcare services.

Young women in tertiary institutions constitute a strategic group for cervical cancer prevention efforts. Although they are within an age bracket where sexual activity and risk of HPV exposure commonly begin, multiple studies have shown that awareness and uptake of cervical cancer screening and HPV vaccination remain low among this group despite their educational advantage. Conducting this study in tertiary institutions therefore provides a suitable platform for identifying knowledge gaps and strengthening targeted preventive health education.

The mean age of respondents (25.305 ± 8.195) aligns with the reproductive age group most at risk for HPV infection and cervical cancer. Out of the 396 respondents, 79.0% were Christians, 82.1% were Yoruba. 97.5% were full time students, 48.5% were from 100 level, and 93.9% were single. Overall Results revealed that 52.0% had good knowledge of cervical cancer prevention. 77.0% had bad practice towards cervical cancer prevention, and 52.0% had negative attitude towards cervical cancer prevention.

The result from this finding reflects the demographic profile of Osun State and is similar to findings in other Nigerian tertiary-institution-based studies^{[14, 15]}. The high proportion of single women (93.9%) suggests an opportunity for early preventive interventions before marriage and childbearing.

The study highlights that only 52% of the study respondents have adequate knowledge of cervical cancer prevention, while 48% lack sufficient awareness. This indicates a substantial gap in knowledge despite the presence of health information sources, pointing to missed opportunities for education and awareness-building among this population. This result is consistent with findings from Adebayo et al. (2021)^[14], who noted similar knowledge levels (60.6%) among antenatal attendees in Ibadan, and Ekwonwa et al. (2017)^[15], where knowledge levels were even higher (72.8%) among reproductive-age women in Ede South. This pattern suggests that women within healthcare settings, like antenatal clinics, may have more access to cervical cancer information than those in other environments.

However, the results contrast with Ogbonna (2017)^[16], where less than half of the respondents displayed adequate knowledge. This discrepancy may reflect differences in education access, geographic or socioeconomic backgrounds, and healthcare exposure across study populations. Although most respondents in the article’s study were aware of the HPV vaccine and the benefits of early screening, many were unfamiliar with the terminology, such as what a Pap smear is. This detail signals potential deficiencies in the clarity and comprehensiveness of health messaging, where specific terms and procedural information may not be fully explained or emphasized, possibly leading to misunderstandings about preventive measures.

Health workers and media emerged as the most common sources of information for the study respondents, consistent with findings by Duru et al. (2015)^[17] and Ilika (2016)^[18]. This reliance on health workers underscores the critical role healthcare professionals play in disseminating accurate health information. However, the mass media’s significant influence highlights both an opportunity and a challenge: while media can reach large audiences, it can also convey unfiltered or incorrect information. This risk may partially explain why knowledge and attitudes toward cervical cancer prevention remain inconsistent or limited.

While knowledge is moderate, attitudes toward cervical cancer prevention were notably negative in over half (52%) of the respondents. This outcome contrasts with Mullatu et al. (2017)^[19], where a majority of female students at Mizan Tepi University held positive attitudes. The article attributes this difference to unfiltered information, particularly from non-healthcare sources, that may foster misconceptions. This finding reflects a broader issue where partial or inaccurate information can hinder preventive attitudes, as also noted by Sajid et al. (2019)^[20], who reported that over half of their respondents’ believed screening was unnecessary without symptoms. This underscores the need for accurate, trusted health information to shift attitudes positively. Negative attitudes among respondents could contribute to low engagement in preventive behaviours, as individuals are less likely to seek services they do not prioritize or fully understand.

The practice of preventive behaviours like screening and HPV vaccination is markedly low among the respondents, with 77% showing poor preventive practices. Despite having some knowledge, most respondents have not acted on it, as evidenced by 74.5% who never underwent HPV testing, 72.5% who never received the HPV vaccine, and 58.6% who never participated in cervical cancer screening. This gap between knowledge and practice is consistent with other studies, such as Nowomuhangi (2019)^[21], where only half of the first-year nursing students had undergone screening, and Rahmat, A. et al. (2021)^[22], which found a 30% screening uptake among respondents. This pattern suggests a systemic issue across Africa, where knowledge is present but does not translate into action due to barriers like access to healthcare, affordability of preventive measures, cultural beliefs, and potentially low risk perception.

The absence of significant associations between knowledge, and attitude (χ²=2.54, p = 0.121; χ²=0.03, p = 0.905) suggests that cognitive awareness does not necessarily translate into behavioural change. This supports behavioural theory, which emphasizes that enabling environments, affordability, and cultural acceptance are as important as individual knowledge in shaping preventive practices^[7].

The findings underscore a critical need for enhanced education and practical interventions to bridge the knowledge-attitude-practice (KAP) gap. Health programmes must focus on clear communication, addressing misconceptions, and creating accessible channels for screening and vaccination. Additionally, policy measures that subsidize or integrate HPV vaccines and screenings into regular health services could significantly improve preventive practice uptake. These actions would address the practical challenges that hinder behaviour change, helping align knowledge and attitude with consistent preventive practices.

In summary, while this study reveals that awareness is present among reproductive-age women, barriers rooted in information quality, cultural context, and systemic healthcare access issues prevent this knowledge from translating into preventive actions. These insights indicate a need for tailored health interventions that directly address the structural and cultural barriers to cervical cancer prevention in Nigeria and similar settings.

To address the gaps identified in this study, the following recommendations are proposed:

For Practice and Policy

For Health Education and Public Awareness

For Future Research and Development

By implementing these recommendations, public health stakeholders and educational institutions can create a supportive environment for cervical cancer prevention, ensuring that knowledge and positive attitudes translate into tangible preventive actions among women in Nigeria and similar contexts.