Cervical cancer and screening: Knowledge, attitudes, and adherence among university students in Italy

The objectives of this cross-sectional survey were to assess the knowledge, attitudes, and practices toward cervical cancer screening among female university students in Italy and to identify the associated determinants. The survey was conducted in July and September 2025 in Caserta and Naples, involving 1003 respondents. The average knowledge score regarding human papillomavirus (HPV) infection and cervical cancer was 12.6 out of 20, with only 2% achieving the maximum score. Knowledge was significantly higher among participants who were older, those in the medical field, those vaccinated against HPV, those who had oral sex, and those who received information from healthcare workers (HCWs). Only 12.7% perceived themselves at high risk for HPV-related cancer, with higher concern among those not in the medical field and those who had acquired information from HCWs. More than half (56.9%) considered Pap test useful, and this was more likely among older participants, those with a higher knowledge score, those who had received HPV vaccination, and those who had acquired information from HCWs. Among screening-eligible students aged ≥25 y, 65.1% had undergone cervical cancer screening, and 72.7% adhered to the recommended intervals. Screening uptake was higher among those older and those who had engaged in sexual intercourse. These findings highlight the urgent need for targeted health education interventions, optimized HCW communication, and the dissemination of information to improve awareness, risk perception, and cervical cancer screening uptake.