Inequalities in cervical screening practices in Europe

Abstract

Cervical cancer is an important public health problem in Europe. The overall incidence of cervical cancer in Europe is 11.6 per 10 5 but morbidity and mortality rates differ significantly, country by country, being much lower in Western Europe where prevention programmes are better developed as compared to Central and Eastern Europe where the screening facilities - for several reasons - are underdeveloped. The effectiveness is in close correlation with the intensity of organized screening. Ideally, cervical cancer screening should reduce the burden of disease in terms of death, morbidity, and improved quality of life. Unfortunately, not everyone benefits equally from the screening due to inequalities of various kinds, such as differences in geopolitical status, diversity in health care systems, access to screening services, socioeconomic and demographic status, lack of knowledge and education. Personal invitation has a major role to play. The acceptance of the offered screening is positively influenced by better access to screening facilities, health consciousness of the invitees, and the quality of pre-screening information. Increasing the uptake of cervical screening remains a challenge in reducing health inequalities in European countries.