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Adherence to HPV-Based Cervical Cancer Screening: A Concept Analysis for Nursing and Midwifery Practice
Cristina Lumia1, Simona Fumagalli1, Marianna Martinelli1
1School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Journal of Multidisciplinary Healthcare
|May 7, 2026
Summary
Adherence to human papillomavirus (HPV) screening is crucial for cervical cancer prevention. Understanding adherence complexities, including knowledge and support, helps nurses and midwives improve screening participation and outcomes.
Area of Science:
- Oncology
- Public Health
- Nursing
Background:
- Human papillomavirus (HPV) infection is a leading cause of cervical cancer globally.
- Suboptimal participation in HPV-based screening limits program effectiveness and equity.
- Nurses and midwives require a clear conceptualization of adherence to guide practice and policy.
Purpose of the Study:
- To analyze the concept of adherence to HPV-based cervical cancer screening.
- To propose an operationally useful framework for nursing and midwifery practice.
Main Methods:
- Literature review of 38 peer-reviewed studies (1997-2025) from PubMed, CINAHL, and PsycINFO.
- Application of Walker and Avant's concept analysis method.
- Definition of adherence as sustained participation in recommended screening pathways.
Main Results:
- Adherence attributes include knowledge, awareness, and empowerment.
- Antecedents of adherence involve education and social support.
- Moderators include age, gender, and counseling; mediators are anxiety, fear, and perceived need.
Conclusions:
- Adherence is a complex, ongoing phenomenon, not a single event.
- Tailored, nurse- and midwife-led strategies can enhance equitable cervical cancer prevention.
- Improved adherence supports better health outcomes and reduced healthcare costs.
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