Trends and Determinants in Uptake of Cervical Cancer Screening in Spain: An Analysis of National Surveys from 2017 and 2020

SIMPLE SUMMARY: Cervical cancer is the fourth leading cause of death and morbidity in women worldwide. Although screening is a successful technique for lowering these rates, there are still great differences in screening adherence in Spain. The aims of this study were to examine the evolution of cytology screening adherence from 2017 and 2020 and to identify the factors associated with uptake among women in Spain. We found that 73.18% of women had received a cytology test during the previous three years. From 2017 and 2020, there was an increase in cytology screening participation among women aged 45–65 years. Foreigners were less likely to have a cytology test. The characteristics associated with cervical cancer screening that we discovered have significant value for public health initiatives, as they will assist health professionals in identifying women who are less likely to undergo screening and encouraging these women to do so. ABSTRACT: Cervical cancer rates have declined in industrialized nations as a result of cytology screening programs. However, there are still sizeable differences in screening adherence in Spain. This study aimed to identify the prevalence of cervical cancer screening among women in Spain, to analyze trends in that prevalence from 2017 and 2020 and to identify socio-demographic, health, and lifestyle factors related with adherence to this screening test. We conducted a cross-sectional study of 13,619 women aged 25–65 who participated in the 2017 Spanish National Health Survey and the 2020 European Health Survey for Spain. We used logistic regression to examine the relationship between socio-demographic, health and lifestyle factors and cervical cancer adherence. The prevalence of adherence was 73.18%. Additionally, there was a significant decrease in cervical cancer screening uptake from 2017 and 2020 among women aged 25–44 years (2017: 77.80%, 2020: 75.20%, p = 0.02), but an increase in the age group of 45–65 years (2017: 68.93%, 2020: 72.39%, p < 0.01) and in foreigners (2017: 64.29%, 2020: 72.29%, p < 0.01). Screening for cervical cancer is related with age, educational level, social class, insurance status, visits to the family doctor, alcohol consumption and free time physical exercise.