Cervical cancer: A cross-sectional study of knowledge, attitudes, perceptions, and barriers to screening and prevention among female university students

A total of 277 female students from 11 specialties participated in an online cross-sectional survey at the Medical University of Sofia. Differences between specialties were observed in knowledge of human papillomavirus transmission, understanding of Pap smear results, testing practices, and vaccination. Despite generally satisfactory awareness, gaps in preventive knowledge and practices remained among some student groups. Lack of time, insufficient information, fear, and embarrassment were identified as the main barriers to screening. Regression analysis identified specialty, age, year of study, parental education, place of residence, and understanding of Pap smear results as factors associated with variations in knowledge and preventive practices. The findings indicate that health-related education alone does not ensure consistent preventive behavior. More targeted and comprehensive educational interventions addressing human papillomavirus, screening, and vaccination may strengthen preventive practices among future healthcare professionals.