Background:

Hepatitis B virus (HBV) remains a major contributor to infection-related cancers in low- and middle-income countries (LMICs), particularly hepatocellular carcinoma. In Nigeria, gaps in public awareness, fragmented prevention services, and weak referral pathways continue to limit effective HBV prevention and early intervention. These challenges disproportionately affect children, adolescents, and young adults, underscoring the need for prevention strategies that move beyond policy frameworks to practical, community-level implementation.
 
Objectives:

To examine how a community-led implementation model can operationalize hepatitis B–related cancer prevention in low-resource settings, and to generate practical implementation and policy-relevant lessons on improving awareness, service uptake, and referral linkages for infection-related cancer prevention in Northern Nigeria.

Methods:

This work describes a community-led cancer prevention initiative implemented between November 2024 and November 2025 through the Slum and Rural Health Initiative (SRHIN) in Northern Nigeria. Using a qualitative implementation approach, the program integrated HBV-focused cancer education, community screening and referral linkages, school-based awareness activities, and engagement with local health facilities.
Program activities were documented through field reports, participant feedback, and stakeholder reflections. A thematic analysis was conducted to identify recurring patterns related to awareness, access, engagement, and system-level coordination within resource-constrained communities.

Results:

Early implementation findings revealed six key themes: 1. Low baseline awareness of HBV–cancer links prior to intervention. 2. Increased community understanding following targeted education. 3. Improved acceptance of screening and vaccination referrals. 4. Trust-building through locally embedded volunteers. 5. Persistent structural barriers, including cost and service availability. 6. Strengthened informal referral linkages between communities and health facilities. Participation increased across community and school settings, with qualitative evidence of greater willingness to seek preventive services.
 
Discussion:

These findings highlight the gap between national prevention policies and their on-the-ground execution. HBV-related cancer prevention represents a high-impact entry point for cancer control in LMICs, but effectiveness depends on culturally grounded delivery, community trust, and functional referral pathways. Community-led models can help operationalize prevention policies where formal systems are limited.

Conclusion:

Community-embedded approaches to HBV-related cancer prevention can enhance policy implementation, equity, and sustainability in low-resource settings. This model offers transferable lessons for strengthening infection-related cancer prevention across LMIC contexts.