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.