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International barriers and facilitators for cervical cancer screening among young women: a systematic review
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  • Abirami Kirubarajan,
  • Shannon Leung,
  • Xinglin Li,
  • Matthew Yau,
  • Mara Sobel
Abirami Kirubarajan
University of Toronto
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Shannon Leung
University of Toronto
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Xinglin Li
University of Toronto
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Matthew Yau
University of Toronto
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Mara Sobel
University of Toronto
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Abstract

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 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 women 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 women, 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 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 Health systems worldwide should address the barriers and facilitators to increase cervical cancer screening rates in young women. Further research is required to understand this age group.