BACKGROUND:
Head and neck cancer (HNC) disproportionately affects populations in low- and middle-income countries, where late diagnosis contributes to poor outcomes and persistent health inequities. Primary healthcare (PHC) nurses play a key role in early detection; however, their effectiveness depends on adequate knowledge, positive attitudes, and appropriate clinical practices. Strengthening PHC capacity offers a practical strategy to improve early detection. This study assessed baseline knowledge, attitudes, and practices (KAP) of PHC nurses regarding HNC prior to an educational intervention aimed at reducing diagnostic delays.

METHODS:
A cross-sectional pre-intervention survey was conducted among 199 PHC nurses using a structured, self-administered KAP questionnaire. The survey assessed knowledge of HNC sites, attitudes towards early detection and screening, and clinical practices related to screening, patient education, and referral. Descriptive statistics were used to summarize findings.

RESULTS:
Participants were predominantly female (94%), with the largest proportion aged 45–54 years (37%). Knowledge of common HNC sites, including the oral cavity and larynx, was adequate. Attitudes towards early detection were largely positive, with most nurses expressing willingness to participate in HNC screening. Despite this, clinical practices were suboptimal. Most nurses reported rarely or never performing routine HNC screening, limited confidence in head and neck examination, infrequent patient education, and lack of access to referral guidelines.

CONCLUSIONS:
The study demonstrates a substantial knowledge-to-practice gap limiting equitable access to early HNC diagnosis. Targeted educational interventions at the PHC level offer a feasible and sustainable strategy to strengthen early detection and reduce cancer-related inequities in resource-limited settings.