Factors Affecting the Cervical Cancer Screening Behaviors of Japanese Women in Their 20s and 30s Using a Health Belief Model: A Cross-Sectional Study

Abstract

In recent years, the incidence and mortality rates of cervical cancer (CC) have increased among young women. Cervical cancer screening (CCS) is crucial to reducing the incidence and mortality of CC in a country such as Japan, where it is challenging to raise HPV vaccination rates. The purpose of this study was to identify psychological and personal characteristics relating to CCS participation among young people by using the Health Belief Model (HBM). For this cross-sectional study, an internet survey was conducted between February–March 2018. Based on HBM and personal characteristics, χ2 tests and logistic analyses were used to identify factors influencing CCS. Responses obtained from 816 women in their 20s and 30s were used in the analysis. For HBM-based psychological characteristics, the odds ratios were significantly higher for “cues to participation in screening” and “barriers to participation at the time of cancer screening”, while “barriers to participation before cancer screening” showed significantly lower odds ratios. On the other hand, it was found that the presence of children and having regular health checkups affected the attributes of screening that were significant for decision-making. Therefore, it is important to create proactive measures to encourage younger women to undergo medical examinations.

Factors affecting cervical screening using the health belief model during the last decade: A systematic review and meta‐analysis

“…the other hand, studies reporting similar findings to ours attribute the lack of adherence to lack of experience, inaccessibility of knowledge, and lack of motivation due to the absence of symptoms. 4,6 Moreover, we have demonstrated that married females or those with higher levels of education are also associated with favorable perceptions toward preventive behaviors; an observation with trends for breast and colorectal cancer screening. 36,37 While the latter is merely a function of improved knowledge, the earlier observation warrants further investigation.…”

“…Interestingly, no studies originated from the Middle East and North Africa (MENA) region. The earliest studies were published in 2007 and the latest were circulated during 2022 4,16,17 . The studies included a total of 15,365 participants with studies contributing at least 171 participants to a maximum of 3249 participants.…”

“…6 Unlike most cancers, cervical cancer can be entirely prevented by HPV vaccination (i.e., primary prevention) and cervical cancer screening (i.e., secondary prevention). 4 Besides its low cost, cervical cancer screening through pap smear testing has proven its effectiveness in detecting cervical cancer within its pre-cancerous or early stages and is reported to reduce cervical cancer incidence by 79%. 3 A meta-analysis of 12 case-control studies also demonstrated a strong link between cytology-based screening and the reduced risk of invasive cervical cancer.…”

“…2,3 It is also noted that rates of cervical cancer-related morbidity and mortality do significantly differ among different age brackets, particularly among those in their 20s and 30s. 4 The World Health Organization recognized cervical cancer as the first oncologic entity that is purely attributed to infection as it is mediated by high-risk strains of human papilloma virus (HPV). 5 Besides HPV, cervical cancer is associated with risk factors such as early sexual interaction, smoking, defective immunity, and other sexually transmitted diseases.…”

“…In addition to the well‐documented sociodemographic and cultural factors that influence screening uptake by women, 9 it is of vital importance to examine the psychosocial factors such as beliefs, perceptions, and emotions as mediators of cervical cancer screening as they are easier to modify than their sociodemographic counterparts. Several European‐ and USA‐based studies were conducted as means to improve cervical cancer screening uptake using theories of behavioral science, 4 of those, the health belief model (HBM) is the most prevalent. The HBM, proposed by Rosenstock in 1966, aims to explain the widespread acceptance or failure of individuals to participate in disease prevention programs 3 .…”