Understanding sub-optimal cervical cancer prevention programs uptake of Romanian women

Abstract

Background: Participation in cervical cancer prevention programs, including Pap and HPV screening and HPV vaccine acceptance, is crucial for reducing the incidence of cervical cancer. This paper aims to describe the structural, cultural, social and individual barriers to cervical cancer prevention among Romanian women. Methods: A mixed method design was used: in-depth interviews, focus-groups, discussion forums, media reports, and quantitative surveys to assess knowledge, beliefs, attitudes, and behavior related to Pap test and HPV vaccine. Content and thematic analysis was performed on qualitative data, and regression analysis was used to identify predictors of screening intention and behavior. Results have revealed limited knowledge or confusion over the efficiency of Pap test and HPV vaccine, fears of side effects, reduced cervical cancer risk perception. Systemic barriers have a direct influence on the screening behaviour and this is partially mediated by perceived control and social norms. Discussion: findings suggest a need to increase public health literacy in relation to primary and secondary cervical cancer prevention, as well as structural changes to insure equal access of all women to prevention programs.