ArticleBMC women's health2026
The role of the health belief model and HPV self-testing in cervical cancer screening participation in the Czech Republic.
Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe aim of this study was to apply the Champion’s Health Belief Model Scale (CHBMS) to: 1) assess the health beliefs and attitudes associated with previous participation in the national cervical cancer screening program among eligible women in the Czech Republic and; 2)analyze the potential increase in motivation to participate in cervical cancer screening if a home-based HPV self-sampling test were available as an alternative to the conventional Pap smear test performed by a gynecologist.
methodsA cross-sectional, population-based study was conducted on a representative sample of women eligible for cervical cancer screening in the Czech Republic in March-April 2025. Overall, 1500 women were recruited for the survey and interviewed using the CHBMS.
resultsWe found that 61% of eligible women reported prior participation in cervical cancer screening. Their participation was strongly associated with perceived benefits (OR 1.6, 95%CI:1.3-2), self-efficacy (OR 1.6, 95%CI: 1.2-2) and perceived barriers (OR 0.4, 95%CI:0.32–0.51), even after adjusting for age, education and monthly income. The availability of a home-based self-administered HPV test instead of a cytological exam performed by a gynecologist would increase the motivation to participate in the screening program in 29% of the eligible women. This increased motivation was strongly associated with the willingness of women to perform the self-test (OR 5.8, 95%CI:4.3–8.1) and with the availability of full coverage of the cost by health insurance (OR 2.0, 95%CI: 1.6–2.5). On the other hand, fear of test misuse and the willingness to follow-up with the physician after the self-test significantly reduced this motivation – OR 0.65 (95%CI: 0.55–0.77) and 0.46 (95%CI: 0.36–0.59), respectively.
conclusionsThis study demonstrates that perceived barriers, benefits, and self-efficacy are key drivers of cervical cancer screening participation in the Czech Republic. Self-administered HPV testing offers a promising approach to increase motivation and coverage, especially among under-screened women. Addressing barriers, highlighting benefits, and ensuring effective follow-up can help achieve the WHO’s 70% screening target and reduce cervical cancer incidence. These results provide a basis for targeted public health interventions and call for future studies on the real-world implementation of HPV self-sampling in the Czech HPV-based screening transition, including provider perspectives on integration.
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