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Research article
Barriers and Facilitators for Cervical Cancer Screening Among Young Women: A Systematic Review
Abirami Kirubarajan
University of Toronto
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9807-5024
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 women globally.
Methods
We 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.
Results
Of 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.
Keywords
Cervical cancer, young women, screening, social determinants of health, patient preference
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CURRENT STATUS: Under Review
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Received 06 Dec, 2020
Editorial decision: Major revision
On 06 Dec, 2020
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On 05 Nov, 2020
Review #1 received
Received 31 Oct, 2020
Reviewer #1 agreed
On 14 Oct, 2020
Editor assigned
On 21 Sep, 2020
Reviewers invited
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On 20 Sep, 2020
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On 20 Sep, 2020
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This preprint is under consideration at BMC Women's Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Barriers and Facilitators for Cervical Cancer Screening Among Young Women: A Systematic Review
Abirami Kirubarajan
University of Toronto
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9807-5024
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 24 Sep, 2020
No community comments so far
Review #2 received
Received 06 Dec, 2020
Editorial decision: Major revision
On 06 Dec, 2020
Reviewer #2 agreed
On 05 Nov, 2020
Review #1 received
Received 31 Oct, 2020
Reviewer #1 agreed
On 14 Oct, 2020
Editor assigned
On 21 Sep, 2020
Reviewers invited
Invitations sent on 21 Sep, 2020
Submission checks complete
On 20 Sep, 2020
Editor invited
On 20 Sep, 2020
First submitted
On 22 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 women globally.
Methods
We 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.
Results
Of 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.
Figure 1