scholarly journals Barriers and Facilitators for Cervical Cancer Screening Among Young Women: A Systematic Review

2020 ◽  
Author(s):  
Abirami Kirubarajan ◽  
Shannon Leung ◽  
Xinglin Li ◽  
Matthew Yau ◽  
Mara Sobel

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.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.MethodsWe conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Databases were examined from inception until the date of our literature searches (12/03/2020). We only examined original, peer-reviewed literature. 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. All screening, extraction, and synthesis was completed in duplicate with two independent reviewers. Outcomes were summarized descriptively. Risk of bias for individual studies was graded using an adapted rating scale based on the Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices.ResultsOf 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 There are unique barriers and facilitators that affect cervical cancer screening rates in young women. Health systems worldwide should address the challenges for this population.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abirami Kirubarajan ◽  
Shannon Leung ◽  
Xinglin Li ◽  
Matthew Yau ◽  
Mara Sobel

Abstract Background Though cervical cancer is one of the leading causes of cancer-related death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening as this population has historically been under-screened. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines. The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening (CCS) among adolescents and young people globally. Methods We conducted a systematic review following PRISMA guidelines of three key databases: Medline-OVID, EMBASE, and CINAHL. Supplementary searches were done through ClinicialTrials.Gov and Scopus. Databases were examined from 1946 until the date of our literature searches on March 12th 2020. We only examined original, peer-reviewed literature. Articles were excluded if they did not specifically discuss CCS, were not specific to individuals under the age of 35, or did not report outcomes or evaluation. All screening, extraction, and synthesis was completed in duplicate with two independent reviewers. Outcomes were summarized descriptively. Risk of bias for individual studies was graded using an adapted rating scale based on the Risk of Bias Instrument for Cross-Sectional Surveys of Attitudes and Practices. Results Of the 2177 original database citations, we included 36 studies that met inclusion criteria. The 36 studies included a total of 14,362 participants, and around half (17/36, 47.2%) of studies specifically targeted students. The majority of studies (31/36, 86.1%) discussed barriers and facilitators to Pap testing specifically, while one study analyzed self-sampling (1/36, 2.8%), one study targeted HPV DNA testing (1/36, 2.8%), and the remainder (4/36, 11.1%) were not specified. 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 systemic barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. Conclusion There are unique barriers and facilitators that affect CCS rates in adolescents and young people. Health systems and healthcare providers worldwide should address the challenges for this unique population.


Author(s):  
Abirami Kirubarajan ◽  
Shannon Leung ◽  
Xinglin Li ◽  
Matthew Yau ◽  
Mara Sobel

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.


2014 ◽  
Vol 53 (4) ◽  
pp. 445-451 ◽  
Author(s):  
Rebecca Albrow ◽  
Karin Blomberg ◽  
Henry Kitchener ◽  
Loretta Brabin ◽  
Julietta Patnick ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249960
Author(s):  
Agajie Likie Bogale ◽  
Tilahun Teklehaymanot ◽  
Jemal Haidar Ali ◽  
Getnet Mitike Kassie

Background To establish successful strategies and increasing the utilization of preventive services, there is a need to explore the extent to which the general female population is aware and use the service for cervical cancer-screening among women infected with HIV in Africa. Available evidences in this regard are controversial and non-conclusive on this potential issue and therefore, we estimated the pooled effect of the proportion of knowledge, attitude and practice of HIV infected African women towards cervical cancer screening to generate evidence for improved prevention strategies. Methods We applied a systematic review and meta-analysis of studies conducted in Africa and reported the proportion of knowledge, attitude and practice towards cervical cancer screening. We searched electronic databases: PubMed/Medline, SCOPUS, ScienceDirect, Web of science, Cumulative Index of Nursing and allied Health Sciences (CINAHL) and Google scholar databases to retrieve papers published in English language till August 2020. We used random-effects model to estimate the pooled effect, and funnel plot to assess publication bias. The registration number of this review study protocol is CRD42020210879. Results In this review, we included eight published papers comprising 2,186 participants. The estimated pooled proportion of knowledge of the participants was 43.0% (95%CI:23.0–64.0) while the pooled estimates of attitudes and practices were 38.0% (95%CI: 1.0–77.0) and 41.0% (95%CI: 4.0–77.0), respectively. The proportion of the outcome variables were extremely heterogeneous across the studies with I2> 98%). Conclusion The pooled estimates of knowledge, attitude and practice were lower than other middle income countries calls for further activities to enhance the uptake of the services and establish successful strategies.


AIDS Care ◽  
2014 ◽  
Vol 26 (10) ◽  
pp. 1229-1235 ◽  
Author(s):  
Faith E. Fletcher ◽  
Meredith Buchberg ◽  
Leslie R. Schover ◽  
Karen Basen-Engquist ◽  
Mirjam-Colette Kempf ◽  
...  

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Sunday Joseph Ayamolowo ◽  
Lydia Feyisayo Akinrinde ◽  
Monisola Omoyeni Oginni ◽  
Love Bukola Ayamolowo

The global incidence of cancer is rising, and low-income and lower-middle-income countries have the worst figures. However, knowledge of cervical cancer prevention and cervical cancer screening practices remains poor in these regions. This study assessed the concept of health literacy as a potential determinant of knowledge of cervical cancer prevention and screening practices among female undergraduates. A descriptive cross-sectional study was conducted among 385 female undergraduates at a university in southwest Nigeria. A validated questionnaire composed of subscales on nine components of health literacy, knowledge of cervical cancer prevention, and cervical cancer screening practices was used for data collection. The majority of the respondents obtained a high score on most of the components of health literacy and 66% had good knowledge of cervical cancer prevention. Only 11% demonstrated good practices of Pap smear testing. Of all the components of health literacy, “feeling understood and supported by healthcare providers” (OR = 0.075; 95% CI [0.036–0.115]; p = 0.015) and “understanding health information well enough to know what to do” (OR = 0.055; 95% CI [0.006–0.104]; p = 0.029) were significantly associated with knowledge of cervical cancer prevention. Out of the major challenges related to cervical cancer screening among undergraduates, the feeling of being at risk (OR = 4.71; p < 0.05) and uncomfortable experiences from past screening (OR = 0.12; p < 0.05) were significantly associated with going for cervical cancer screening. The study concluded that levels of health literacy influenced knowledge of cervical cancer prevention among female undergraduates, but it did not affect their engagement in cervical cancer screening practices.


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