Exploring barriers to women’s participation in breast and cervical cancer screening programs: insights from national health surveys in Türkiye

OpenAlex İngilizce

BACKGROUND: The utilization of breast and cervical cancer screening services among women remains low in Turkiye, despite their importance for early diagnosis. Therefore, this study examines the influences of financial and physical barriers in accessing healthcare and socio-economic and demographic factors on Turkish women's participation in mammography and Pap smear screenings. METHODS: The microdata from the Turkey Health Survey (TSA) conducted by the Turkish Statistical Institute (TURKSTAT) in 2014, 2016, 2019, and 2022 were pooled. A total of 26,931 women aged 35 and over were included. To analyze the factors affecting the likelihood of undergoing mammography and Pap smear tests, separate binary logistic regression (logit) models were estimated for each dependent variable. In the first stage, the effects of the variables were reported as odds ratios, and in the second stage, average marginal effects (AME) were calculated and presented through graphs. RESULTS: Participation rates were 43.73% for breast cancer screening and 43.06% for cervical cancer screening. 20% of women faced financial barriers in accessing healthcare services, while 34% faced physical barriers. Encountering financial barriers, education and income levels, having access to a physician, and performing self-breast examinations were related to the level of mammography and Pap smear screening. CONCLUSIONS: To increase the effectiveness of screening programs, health policies must prioritize reducing financial barriers, promoting healthy behaviors, and improving physician services. Furthermore, strengthening the role of primary care services in this regard would also be a significant contribution. CLINICAL TRIAL: Not applicable.