Economic incentives for cervical cancer screening: A qualitative study of healthcare professionals’ perspectives

Objectives: To explore and describe healthcare professionals' perspectives on the use of economic incentives to increase adherence to cervical cancer screening programmes. Study design: An exploratory-descriptive qualitative design was adopted. Methods: Between April and August 2025, semi-structured interviews were conducted with 24 healthcare professionals from different Italian regions involved in public health. The interview guide was developed through consensus among members of the research team, drawing on the Theoretical Framework of Acceptability. Data were transcribed verbatim and analysed thematically using NVivo version 15. Results: The analysis identified three overarching thematic areas: 1. ethical implications of using economic incentives in public health; 2. trust-based relationships between women and healthcare professionals; and 3. preexisting stigma associated with HPV. Participants considered economic incentives as potentially useful tools to encourage participation and reduce structural barriers, but ethically acceptable only when supporting women's health and autonomy rather than replacing intrinsic motivation or relational care. Concerns were raised regarding potential dependency on incentives, socio-economic inequalities and possible effects on trust. Educational determinants, organisational barriers to screening access, and the integration of cervical cancer screening and HPV vaccination were also highlighted.; barriers to access to screenings; and the integration of screening and vaccination. Conclusions: Economic incentives may represent an effective strategy to increase adherence to cervical cancer screening if interventions are designed with attention to ethical principles, social equity, and the socioeducational characteristics of target populations. Project registration in open science framework: osf.io/nrqf4/overview (11/03/2025)