Strengths and Limitations
Strengths of our review include our systematic search of four databases using broad search criteria to maximize findings. Studies were not excluded by basis of date of publication, country of origin, or language of origin. To capture the full breadth of explored research, conference abstracts were included. Our two parallel reviewers had high inter-rater agreement. We also included age ranges up to 35 years, based on what has been completed in previous literature. Limitations include that this review included qualitative studies that may have been limited by selection and publication bias, particularly for lower-income countries that may not be well-represented in academic research. In addition, cervical cancer screening guidelines (e.g. age to start screening) may differ depending on country, which may limit generalizability of results. Survey and interview results may also be compromised by reporting bias, if study participants are potentially embarrassed to discuss barriers or facilitators. More rigorous and systematic research with an equity-focused lens is recommended to generalize results to different populations and obtain higher quality information.