Women's compliance with cervical cancer screening recommendations and associated barriers to participation: A cross-sectional analysis.

Abstract

Cervical cancer screening (CCS) programmes play a key role in the early detection of cervical cancer (CC) and in reducing related morbidity and mortality. However, both under and overscreening deviate from evidence-based guidelines and can result in more harm rather than benefit. This cross-sectional study is aimed to evaluate the compliance of the CCS target group with the national CCS programme and to identify factors associated with different screening frequencies, including sociodemographic characteristics, health status and behaviour, awareness of the prevention of CC and the venue of the study participants' recruitment. A cross-sectional survey was conducted among 1,279 women aged 25-70 years residing in Latvia. Multinomial logistic regression was used to assess associations between CCS frequency (once every three years, biannually or more often, once every four years or less, and "do not remember") and independent variables, such as self-assessed health, chronic diseases, smoking and binge drinking, condom use and number of sexual partners and awareness of CCS invitation frequency, understanding of the frequency and purpose of the screening test, and knowledge of HPV vaccination, as well as venue of recruitment of study participants (colposcopy patients or general population). All variables were adjusted for key sociodemographic covariates. Overscreening (biannually or more often), underscreening (once every four years or less), and not recalling CCS history were strongly associated with a lack of awareness about the national CCS guidelines (e.g., unawareness that CCS is offered every three years). Overscreening was more common among participants recruited from colposcopy clinic. The results underscored the importance of health literacy in promoting appropriate screening behaviours. Addressing knowledge gaps through accessible and culturally relevant educational interventions could advance equity and enhance the effectiveness of CC prevention strategies.