Barriers and Facilitators for Cervical Cancer Screening Among Young Women: A Systematic Review
Background Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable. Young women have been an international priority for screening. However, in both high-income and low-income countries, young women have not been screened appropriately according to country-specific guidelines.The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening among young
... reening among young women globally.MethodsWe conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Databases were examined from inception until the date of our literature searches (12/03/2020). We only examined original, peer-reviewed literature. Articles were excluded if they did not specifically discuss cervical cancer screening, were not specific to young women, or did not report outcomes or evaluation. All screening, extraction, and synthesis was completed in duplicate with two independent reviewers. Outcomes were summarized descriptively. Risk of bias for individual studies was graded using an adapted rating scale based on the Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices.ResultsOf the 2177 original database citations, we included 36 studies that met inclusion criteria. Our systematic review found that there are three large categories of barriers for young women: lack of knowledge/awareness, negative perceptions of the test, and practical barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy.Conclusions There are unique barriers and facilitators that affect cervical cancer screening rates in young women. Health systems worldwide should address the challenges for this population.