Healthcare access and cervical cancer screening inequities among minority women: a cross-sectional study

Cervical cancer is largely preventable through regular screening and human papillomavirus (HPV) vaccination. However, uptake remains low among minority and underserved populations. Bedouin women in southern Israel represent a vulnerable group characterized by socioeconomic disadvantage and limited access to healthcare services. Evidence on cervical cancer screening behaviours and associated factors in this population is limited. This study aimed to examine the uptake of cervical cancer screening and to identify its associated factors among Bedouin minority women in southern Israel. A cross-sectional study was included 424 Bedouin women aged 25–54 years in southern Israel. Data were collected via face-to-face interviews using a structured questionnaire assessing sociodemographic characteristics, health status, healthcare utilization, HPV vaccination history, and cervical cancer screening. Multivariable logistic regression analysis was conducted to identify independent factors associated with cervical cancer screening. Overall, the rate of cervical cancer screening among participants was 43.2%. Screening uptake was significantly higher among women residing in recognized localities compared to unrecognized villages (47% vs. 36%, p = 0.023). In multivariable analysis, residing in a recognized locality was associated with a higher likelihood of screening (aOR = 2.9, 95% CI: 1.5–5.6). Healthcare utilization factors were also associated with screening uptake, including having visited a gynaecologist in the past 12 months (aOR = 4.5, 95% CI: 2.2–9.6) and having a regular gynaecologist (aOR = 3.3, 95% CI: 1.7–6.1). HPV vaccination history was the strongest associated with screening uptake (aOR = 21.5, 95%CI = 10.7–43.1). Sociodemographic factors such as age, marital status, education, employment, and income were not significantly associated with screening after adjustment. Cervical cancer screening uptake among Bedouin women in southern Israel is low. Fewer than half reported ever having undergone cervical cancer screening. Healthcare access and engagement with preventive services, were more strongly associated with screening uptake than the sociodemographic characteristics assessed. These findings highlight the importance of healthcare access and engagement with gynecologic and preventive healthcare services. Further research is needed to examine structural and health-system barriers, including transportation, provider availability, waiting times and cultural accessibility. Improving access to continuous gynaecologic care, culturally tailored preventive services, and HPV vaccination may enhance screening uptake and reduce health inequities among Bedouin women.