Factors Affecting Cervical Cancer Screening in Primary Care Physician Practices in Ukraine

Purpose Cervical cancer remains a major cause of cancer-related deaths among women in Ukraine. Screening efforts are limited by systemic challenges and the ongoing conflict. This study assessed cervical cancer screening practices, barriers, and facilitators among primary care physicians in Ukraine. Methods We conducted a national cross-sectional survey of internal medicine and family medicine physicians in April-May 2023. The survey gathered data on clinical practices, access to screening tools, use of screening tests, and perceived barriers. Results were analyzed using descriptive statistics and adjusted population estimates. Results Among 292 respondents, most primary care physicians referred patients to gynecologists for cervical cancer screening rather than performing screening themselves. Direct use of screening tests was low: 19.5% used Papanicolaou (Pap) tests, 20.2% used Pap and human papillomavirus (HPV) co-testing, 5.8% used HPV testing, and 4.1% offered self-collection HPV tests. Only 13% of practices had Pap tests available. Key barriers included limited training on the benefits of screening and counseling patients (43.8%), lack of equipment or supplies (34.2%), and absence of reimbursement for procedures (27.7%). Patient-related barriers included low awareness of screening (41.8%), financial constraints (36.0%), and fear of treatment (35.3%). Physicians familiar with national guidelines and with access to screening tools were more likely to implement screening practices. Conclusion Gaps in training, resources, and systemic support constrain cervical cancer screening in Ukraine’s primary care settings. Improving physician education, access to diagnostic tools, and adherence to national guidelines may help to enhance screening uptake and reduce cervical cancer burden.