Barriers and attitudes towards cervical cancer screening in primary healthcare in Poland - doctors’ perspective

Abstract

Background Healthcare systems have adopted different strategies to reduce the burden of cervical cancer. In Poland, a population-based screening program was implemented in 2006, leading to a downward trend in cervical cancer burden. However, screening rates are still low in relation to other EU member states. In Poland, Pap smears are mainly performed by gynecologists rather than Primary Health Care (PHC) physicians. Little is known about the experiences and attitudes of the latter regarding cervical cancer screening in a PHC setting. Methods A cross-sectional questionnaire-based survey was carried out among 43 PHC physicians from the Malopolska region in Poland. Barriers and attitudes towards cytology in a PHC setting were evaluated. Results Approximately 35% of surveyed physicians reported having experience in performing cytology. Almost 75% of PHC physicians lacked the necessary equipment in their office to perform the screening. None of the studied physicians performed Pap smears in their office at the time. The reasons included: shortage of competence (78.57%) and time (69.05%), the perception of Pap smears as a task for gynecologists (69.05%), the lack of financial incentives (61.90%), and the belief that their patients would be unwilling to undergo the test in their PHC physician’s office (33.33%). More than three quarters (76.74%) declared they would be ready to perform Pap smears if the tests were additionally paid. No significant associations between PHC physicians’ characteristics and their willingness to perform cytology screening were found. Conclusion The primary barrier to perform Pap smears by PHC physicians does not lie in their personal reluctance but in the organization of the healthcare system. Provision of required training and proper funding allocation can likely improve the screening rate of cervical cancer in Poland.

Willingness of healthcare providers to perform population-based cancer screening: a cross-sectional study in primary healthcare institutions in Tianjin, China

“…We did not find that geolocation (urban vs rural) was associated with the willingness of the healthcare provider to perform these cancer screenings, which is similar to a previous study. 39 An explanation might be that primary healthcare institutions in Tianjin, whether in urban or rural areas, are geographically located in densely populated areas that are easily accessible. 40 Additionally, with urbanisation, several rural areas are now close to urban areas, resulting in narrowing differences between urban and rural areas.…”

Survey on cervical cancer knowledge and its influencing factors among 2,578 women in Shache county, Kashi, China

“…Among the survey respondents, there were 8 channels of knowledge acquisition, and only 9.9% (254/2578) had more than 4 channels of acquisition, among which the most frequent sources of acquisition were community health prevention institutions or medical institutions, followed by community-issued leaflets, then county-level hospitals and above, and the lowest were newspapers and blackboards. National and international studies have shown [ 27 , 28 ] that regular visits to physicians can awake and reinforce women’s health awareness and motivate them to learn about cervical cancer screening initiatively. In addition, the study still found that women who received lectures from professionals scored much higher than those who received them through other means, which is consistent with the Bo Song’s study [ 11 ].…”

Preventive Health Screening during the COVID-19 Pandemic: A Cross-Sectional Survey among 102,928 Internet Users in Poland

“…In Poland, cervical cytology (every 3 years) is funded by the public payer (free of charge) for all females aged 25–59 years [ 49 ]. Moreover, multiple educational campaigns offer free access to cervical cytology in local communities [ 50 ]. This study showed that the percentage of females who performed cytology within the last 3 years decreased with the age.…”

“…There is an urgent need for educational campaigns on cervical cancer and screening targeting older females from rural areas and small cities without higher education. Moreover, local government, public opinion leaders, and healthcare professionals should be actively involved in screening programs [ 50 ].…”