The Role of Health Beliefs and HPV Self-Testing in Cervical Cancer Screening Participation in Czechia

Objectives The aim of this study was to use the Champions Health Belief Model Scale (CHBM) to measure beliefs and attitudes influencing participation of eligible women in Czechia in the national cervical cancer screening program and to analyze the potential increase in motivation to participate in screening if a home-based HPV-self test would be available. Methods A 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 CHBM. Results We found that 61% of eligible women reported prior participation in cervical cancer screening. Their participation was strongly predicted by 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 income. The availability of a home-based self-administered HPV test instead of a cytological exam would increase the motivation to participate in the screening program in 29% of the eligible women. This motivation is strongly predicted by the willingness of women to the self-test (OR 5.8, 95%CI:4.3–8.1) and covering the cost by health insurance (OR 2. 95%CI: 1.6–2.5), while fear of test misuse and the willingness to follow-up with the physician after the self-test reduced significantly this motivation – OR 0.65 (95%CI: 0.55–0.77) and 0.46 (95%CI: 0.36–0.59), respectively. Conclusions This study highlights the critical role of perceived barriers, benefits, and self-efficacy in driving cervical cancer screening participation in Czechia. The potential of self-administered HPV testing to increase motivation among underserved groups offers a promising strategy to enhance screening coverage. By addressing barriers, promoting benefits, and ensuring robust follow-up systems, Czechia can make significant progress toward meeting the WHO’s 70% coverage target and reducing its cervical cancer burden. These findings provide a foundation for targeted public health interventions and future research to advance cervical cancer prevention in the region.