Barriers to cervical cancer screening: a cross-sectional study of non-adherent Portuguese women

Cervical cancer is preventable through effective screening programmes, yet adherence remains suboptimal in Portugal. This study aimed to explore the reasons for non-adherence to cervical cancer screening, including socio-demographic influences and women's perceptions, to inform targeted interventions.

A cross-sectional study was conducted among women aged 25-60 years identified as non-adherent to cervical cancer screening within a primary care unit in northern Portugal. Participants were randomly selected and recruited via telephone. Data collection included socio-demographic characteristics, screening history, reasons for non-adherence, and knowledge of cervical cancer.

Among 262 participants, 43.9% were not compliant with recommended screening intervals. The main barriers identified were lack of a healthcare provider's prescription (34.8%), personal discomfort or forgetfulness (17.4%), low health literacy (15.7%), and limited access to facilities (14.8%). Adherence was positively associated with higher education, access to private healthcare, and positive health self-perception, while lower education and overconfidence in symptom recognition were linked to reduced adherence.

Non-adherence to cervical cancer screening reflects a complex interplay of systemic, educational, and personal factors. Addressing these requires improved provider-patient communication, targeted health literacy initiatives, and enhanced service accessibility. Tailored public health strategies are crucial for reducing disparities and supporting national and WHO cervical cancer elimination goals.