Over the past five years, the dynamics of oncogynecological disease indicators has testified to the decline of preventive examinations (routine checkups) in women. It results in adverse effects on the growth of both annual mortality and neglected cases. There is an increased rate of yearly mortality and neglected issues of cervical cancer, as well as neglected ovarian cancer. Oncogynecological disease morbidity and mortality rates are lower in Sumy compared to the region districts, which indicates a lower level of medical services in rural areas. Only 60% of women surveyed undergo preventive gynecological examinations, 46.8% of which have a gynecologist’s appointment once a year. The older a woman is, the less often she turns to specialists or does not attend women’s health clinics at all. Women from villages and settlements are less likely to participate in medical examinations or undergo them at all.
Professionalism and care are the main factors when choosing a gynecologist. However, almost every fifth woman has to choose a gynecologist guided by the proximity to the residence. Women living in rural areas often seek oral advice and do not undergo checkups on a gynecological examination chair. The level of women’s income is also directly related to the number of procedures they have during gynecological examinations. Regarding the associated costs, rural women spend more money and travel time (from 20 to 50 UAH, about 2 hours) to get an appointment with a gynecologist. There is almost no free alternative. The key reason for not visiting a gynecologist is the feeling of discomfort. Women also note that they do not have time, it is difficult for them to get or even book an appointment, they find patient admission schedule to be inconvenient, or the service cost high. Simultaneously, 10.2% of interviewed women self-medicate. Given the elevated women’s mortality rate from cancer, it is vital to implement a comprehensive approach to prevention, early diagnosis, and treatment of cancer in the Sumy region. There are two directions to solve the problem: social, that is, through increasing the culture of cancer prevention, and medical – through the development of a system for diagnosing diseases with the simultaneous overcoming barriers (primarily physical/organizational) in access to available medical services.
Research on the barriers when urban and rural women employ services for prevention and early detection of oncogynecological diseases in the Sumy region comes to life in Sumy State University Center for Social Research. It operates within the “Initiative for the Development of University Analytical Centers” implemented by the International Renaissance Foundation in partnership with the Open Society Initiative for Europe (OSIFE) and with the financial support of the Swedish Embassy in Ukraine.