Missed Opportunities in Cervical Cancer Prevention: Knowledge and Screening Practices Among Women with Hemoglobinopathies in Greece

BACKGROUND: Women with hemoglobinopathies represent a chronically ill population with frequent healthcare contact, yet limited integration into preventive health programs. Despite the proven effectiveness of HPV vaccination and screening, cervical cancer remains a preventable cause of both morbidity and mortality. OBJECTIVE: To assess the levels of knowledge, awareness, and adherence to cervical cancer prevention and screening practices among women with hemoglobinopathies in Greece. METHODS: A cross-sectional study was conducted among 202 women with thalassemia or sickle cell disease, attending a tertiary hospital's Hemoglobinopathy Unit in Athens between December 2023 and March 2024. Data were collected using the validated Cervical Cancer Knowledge and Prevention Questionnaire (CCKP-64) and analyzed with SPSS 25, using descriptive and inferential statistics. RESULTS: Nearly all participants were aware of cervical cancer (98.5%), the Pap test (99.0%), and the HPV vaccine (96.5%). However, only 6.5% were vaccinated against HPV, while 75.2% underwent annual Pap screening. Higher adherence to screening was associated with younger age (p = 0.009), employment status (p = 0.032), and higher income (p = 0.049). Knowledge regarding risk factors was moderate, with 58.4% recognizing HPV infection as the main cause. The most frequent reason for non-compliance was negligence (14.8%). CONCLUSIONS: Despite adequate awareness of cervical cancer and good adherence to Pap testing, HPV vaccination rates remain strikingly low among women with hemoglobinopathies. This highlights missed opportunities to integrate HPV vaccination and education into chronic disease management. Tailored preventive strategies and continuous awareness campaigns are essential to achieving the WHO's 2030 cervical cancer elimination goals.