International barriers and facilitators for cervical cancer screening
among young people: a systematic review
Background Though cervical cancer is one of the leading causes of death
globally, its incidence is nearly entirely preventable. Young people have
been an international priority for screening. However, in both
high-income and low-income countries, young people have not been screened
appropriately according to country-specific guidelines and in many
countries, screening rates for this age-group have even dropped.
Objectives The aim of this systematic review was to systematically
characterize the existing literature on barriers and facilitators for
cervical cancer screening among young people globally. Search Strategy We
conducted a systematic review following PRISMA guidelines of four
databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov.
Selection Criteria We only examined original, peer-reviewed literature.
Databases were examined from inception until the date of our literature
searches (12/03/2020). Articles were excluded if they did not
specifically discuss cervical cancer screening, were not specific to
young people, or did not report outcomes or evaluation. Data Collection
and Analysis All screening and extraction was completed in duplicate
with two independent reviewers. Main 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 people: 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 Health systems
worldwide should address the barriers and facilitators to increase
cervical cancer screening rates in young people. Further research is
required to understand this age group.