Examining cervical cancer screening adherence: how does healthism influence participation?

Background Cervical cancer is a major public health issue. While HPV screening and vaccination are crucialpreventive measures, many countries still struggle to meet the WHO’s participation targets due to a range of systemic,socioeconomic, and psychological barriers. Recent studies suggest that beyond these factors, women’s decisions toattend screening are increasingly shaped by cultural norms that promote health as a personal responsibility, framingparticipation as both a moral obligation and an expression of a responsible lifestyle.Methods This study examines the relationship between a healthy lifestyle and HPV screening participation usingdata from the European Health Interview Survey (EHIS, 2019) for Italy. We use binomial logistic regression as statisticalmethod, with regular screening attendance (versus irregular) as dependent variable.Results Our findings indicate that women who adopt healthier lifestyles—particularly in terms of physical activityand dietary habits—are more likely to participate in pap tests. Furthermore, younger women exhibit higher screeningparticipation rates, with early screening initiation (before age 25) associated with greater long-term adherence.Conclusions These results suggest that healthism, understood as the pursuit of a healthy lifestyle, plays asignificant role in fostering engagement with preventive healthcare measures, although unmeasured confoundersmay influence both healthy behaviors and screening adherence, thereby limiting the causal interpretation of ourfindings. Adopting a sociological perspective on surveillance medicine, we argue that healthism is not merely amoral imperative but can serve as a mechanism for empowered agency, encouraging proactive health behaviours.Our findings may inform complementary public health strategies that promote voluntary screening participationby supporting health-oriented behaviours, rather than relying exclusively on top-down interventions. Recognisingscreening as a social intervention offers a broader analytical framework for addressing cultural and structural barriersto participation, ultimately contributing to more effective and inclusive public health policies.