{
  "abstract": "Background: Despite the 85% desirable participation level set by European guidelines, EU cervical screening averaged only 55% in 2022. Ecological evidence integrating socioeconomic, health-system, well-being and epidemiological domains in one model is scarce.\n\nMethods: Ecological pooled time-series analysis of cervical screening coverage rates (SCRs) in women aged 20-69 in 19 European countries, 2013-2023, using OECD, Eurostat, World Bank and UNICEF data. Pooled and country-specific linear/quadratic OLS regressions tested time trends. Univariate logit-normal regressions with bootstrap 95% CIs tested associations with 20 predictors in four domains: socioeconomic, healthcare-system, health/well-being, epidemiological.\n\nResults: Coverage patterns shifted geographically. SCRs ranged from 5.7% (Romania) to 80.5% (Sweden) in 2013, with a comparable spread in 2023. Only Czechia, Finland, Ireland, Slovenia and Sweden maintained the 70% threshold; none reached 85%. The pooled trend was flat. Four countries had an increasing trend (Finland, Latvia, Lithuania, Norway), five high-income countries declined (Denmark, Hungary, Iceland, Netherlands, UK). Cross-sectional analyses found significant associations with educational attainment, income inequality and self-reported screening, and—to our knowledge novel ecologically—a subjective well-being indicator: higher population-level negative affect was associated with lower coverage. No association emerged with healthcare spending or HPV vaccination.\n\nConclusions: European cervical screening stagnated and remained unevenly distributed over 2013-2023, with declines in some high-income systems. Beyond educational and economic inequalities, population-level negative affect appears as a candidate ecological correlate warranting further study. Multimodal strategies reaching the target population (invitations, reminders, HPV self-sampling, outreach) and policies on socioeconomic and well-being determinants may help advance European goals.\n\nKey messages: • Cervical screening coverage stagnated across 19 European countries in 2013-2023; population-level negative affect emerged as a candidate ecological correlate beyond classic determinants.\n\n• Cervical screening policy in Europe should integrate socioeconomic and well-being determinants alongside organised delivery to reduce persistent cross-country inequities.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "abstract",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "P Florio"
    },
    {
      "name": "P Marraffa"
    },
    {
      "name": "GMM Politano"
    },
    {
      "name": "MM Gianino"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5btjsq7yrqgj8.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.1795",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699819/",
  "id": "5btjsq7yrqgj8",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.1795",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "6. Poster Displays"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
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    [
      "heading",
      "AcademicSubjects/SOC01210"
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      "heading",
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    [
      "heading",
      "DS. Promoting Health Equity in Urban and Rural Settings"
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    [
      "openalex",
      "2713|Cervical Cancer and HPV Research"
    ]
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  "openalex": "W7223683845",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13699819/pdf/?tool=EBI",
  "pmcid": "PMC13699819",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/5btjsq7yrqgj8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:22Z",
      "native_id": "PMC13699819",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.1795"
    },
    {
      "first_seen": "2026-10-30T12:21:40Z",
      "native_id": "PMC:PMC13699819",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13699819"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Cervical Cancer and HPV Research",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Cervical cancer screening across 19 European countries: trends and ecological correlates, 2013-2023",
  "title_text": "Cervical cancer screening across 19 European countries: trends and ecological correlates, 2013-2023",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:36:20Z",
  "url": "https://research.draconitic.com/paper/5btjsq7yrqgj8",
  "venue": "The European Journal of Public Health",
  "versions": []
}