Addressing the Critical Gap in Women’s Cancer Prevention in Serbia:High Screening Awareness Versus Low Participation in OrganizedScreening Programmes

Abstract

Breast and cervical cancer prevention in Serbia is marked by a striking contrast: women report high awareness and substantial use of preventive services, yet participation recorded within organized screening programmes remains low. We analysed a cross-sectional online survey conducted nationwide between 19 September and 15 December 2025 among 1,133 women and interpreted the findings against previously published public data from institutional sources.

Ninety-nine per cent of respondents understood screening as testing of people without symptoms. In a breast-prevention subsample (n=456), most women (82.3%) reported never receiving an institutional screening invitation, 15.6% reported receiving one, and 2.1% did not recall. Among invitees with an evaluable response, 90.9% reported attending. Difficulty obtaining an appointment (38%) and lack of time (20%) were the most frequently cited barriers, while 76.8% were willing to share contact details with health authorities to facilitate scheduling. In a cervical-prevention subsample (n=263), 64 women (24.3%) had undergone HPV testing; 64.6% had visited a gynaecologist in the preceding year, yet communication about HPV and vaccination remained limited. Published evidence indicates that programme-based cervical screening reached approximately 6% in 2023, compared with 63% selfreported participation in 2019, and that final-dose HPV vaccination coverage in 2024 was 4% among girls and 2% among boys. The findings support the implementation of systematic invitations, direct scheduling, reminders, flexible appointments, mobile services, stronger clinician communication about HPV, and reliable population-level monitoring.