INTRODUCTION
Cervical cancer is the second most common malignancy among women worldwide, with over 500,000 new cases and 250,000 deaths annually.1-3 The disease is caused by the human papillomavirus (HPV), which is sexually transmitted.1Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable.4Cervical screening and HPV vaccination programs have significantly reduced the mortality of cervical cancer in North America and Europe through secondary prevention. Screening techniques include Papanicolau tests (also known as Pap smears), liquid-based cytology, HPV DNA testing, and visual inspection with acetic acid.5-6Despite the proven effectiveness of cervical cancer screening, there are numerous barriers to uptake, particularly in low-income countries.7
Young women have been a particular area of research focus, due to the preventive benefits of screening from a younger age, increased likelihood of lifelong testing, and setting of new cultural norms.8-11 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.12-16
As a result, numerous interventions have been posited to increase cervical cancer screening among young women.8 However, there has not yet been a systematic assessment of the barriers and facilitators that determine uptake among this age-group. This information would be useful in designing targeted and efficacious interventions. 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.