A. Dzhemiliev1,2, A. Bojko3, D. Kizub4, V. Vus5, I. Huivaniuk6, V. Kopetskyi6, A. Beznosenko6, S. Bielichenko7, M. Kasianchyk8, N. Melnitchouk1,2 1Brigham And Women’s Hospital, Surgery, Boston, MA, USA 2Harvard Medical School, Center For Surgery And Public Health, Boston, MA, USA 3Tufts Medical Center, Obstetrics And Gynecology, Boston, MA, USA 4University Of Texas MD Anderson Cancer Center, Breast Medical Oncology, Houston, TX, USA 5Karpilivka hospital, Family Medicine, Rivne, Ukraine 6National Cancer Institute, Surgery, Kyiv, Ukraine 7Massachusetts General Hospital, Division Of Cardiac Surgery, Boston, MA, USA 8El Paso Medical Center, Houston, TEXAS, USA
Introduction: We explored factors associated with cervical cancer screening in Ukraine given renewed emphasis on cancer early detection due to adverse impact of war on cancer outcomes.
Methods: A survey regarding cervical cancer screening was distributed via social media to primary care physicians (PCPs) in Ukraine. Data were analyzed using descriptive statistics and standard tests of association.
Results: 395 PCPs from 25 (92%) Ukrainian regions completed the survey. 237 (70%) were familiar with the Ministry of Health Order 236 (MOH236), which includes cervical screening guidelines.
Cervical screening via gynecology referral was reported by 311 (90%), pap smear by 66 (19%), HPV/pap co-test by 63 (18%). Gynecologists were available at 155 (45%), pap smear at 46 (13%) and co-testing at 47 (13%) of practices.
Factors independently associated with gynecology referral for screening included: gynecology availability, awareness about MOH236, educational training, patient family history, referring patients for HPV vaccination (all p<0.05).
Factors independently associated with pap smear screening included: pap smear availability, awareness of European cancer screening guidelines, residency training, having personally undergone pap smear, referring patients for HPV vaccination (all p<0.05).
Factors independently associated with screening via HPV/Pap co-testing included: co-test availability, awareness about United States cancer screening guidelines, having personally undergone co-testing, patient family history (all p<0.05).
Conclusion: Patient, physician, healthcare, and policy related factors associated with cervical cancer screening identified in our study can serve as a starting point for strategies to expand cervical cancer screening in Ukraine.