Cervical Cancer Screening Attendance Related Factors among Women in Latvia

Objectives
Latvia has one of the lowest cervical cancer (CC) screening rates in Europe. Identifying subpopulations whose participation does not align with national guidelines could support targeted interventions. This study aimed to identify factors associated with CC screening attendance in Latvia.
Materials and Methods
Data from a cross-sectional study conducted between February 2021 and April 2022 was used including women aged 25–70 years (n=1313) attending 10 selected general practitioner practices or referred to colposcopy clinic for abnormal cervical cytology. Data were collected using a self-administered questionnaire. Multivariate binary logistic regression was used to identify associated factors, adjusting for demographic variables (p<0.05).
Results
Low screening participation (once every four years or less; the reference category – once per three years that fits with the national guidelines) was associated with chronic diseases (OR: 1.73), poor knowledge of screening frequency (OR: 2.07) or method (OR: 4.78), lack of awareness of HPV vaccination (OR: 1.67), and poor healthcare habits, such as a last gynecological visit over three years ago (OR: 7.48). Over-frequent screening (biannual or more frequent) was linked to smoking (OR: 1.50), moderate/high self-rated STI risk (OR: 1.60), six or more lifetime sexual partners (vs. 0-1 OR: 1.68), and poor knowledge of screening frequency (OR: 2.00) or method (OR: 2.48). Odds were lower for women who had no prior cervical cytology (OR: 0.45), no history of follow-up for abnormal smears (OR: 0.50), and longer intervals since their last gynecological visit (OR: 0.31 for more than three years ago).
Conclusions
Non-adherence to CC screening guidelines - whether under- or over-utilization - is associated with both - healthrelated behaviors and awareness