scholarly journals International barriers and facilitators for cervical cancer screening among young people: a systematic review

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.

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.


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.


Author(s):  
Jessica Sormani ◽  
Bruno Kenfack ◽  
Ania Wisniak ◽  
Alida Moukam Datchoua ◽  
Sophie Lemoupa Makajio ◽  
...  

Human papillomavirus (HPV) self-sampling (Self-HPV) is a promising strategy to improve cervical cancer screening coverage in low-income countries. However, issues associated with women who prefer conventional HPV clinical-sampling over HPV self-sampling may affect screening participation. To address this issue, our study assessed factors associated with women’s preferences related to Self-HPV. This study was embedded in a large clinical trial recruiting women aged 30–49 years in a primary HPV-based study termed “3T-Approach” (for Test-Triage-Treatment), launched in 2018 at Dschang District Hospital, West Cameroon. Participants were invited to perform a Self-HPV. After the sampling and before receiving the results, participants completed a questionnaire about cervical cancer screening and their preferences and perceptions around Self-HPV. The median age of the 2201 participants was 40.6 (IQR 35–45) years. Most (1693 (76.9%)) preferred HPV self-sampling or had no preference for either method, and 508 (23.1%) preferred clinician-sampling. Factors associated with an increased likelihood of reporting a clinician-sampling preference were tertiary educational level (29.4% CI: 25.6–33.6 vs. 14.4% CI: 12.8–16.1) and being an employee with higher grade professional or managerial occupations (5.5% CI: 3.8–7.9 vs. 2.7% CI: 2.0–3.5). The main reported reason for women preferring clinician-sampling was a lack of “self-expertise”. Most women (>99%) would agree to repeat HPV self-sampling and would recommend it to their relatives. HPV self-sampling in the cultural context of central Africa was well accepted by participants, but some participants would prefer to undergo clinician sampling. Health systems should support well-educated women to increase self-confidence in using HPV self-sampling.


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 ◽  
...  

2018 ◽  
Vol 1 (7) ◽  
pp. 372
Author(s):  
Clerah R Elia ◽  
Sue Devine

Background: Globally cervical cancer is the fourth most common type of cancer in women and in some low-income countries is the most common cancer in women. Papua New Guinea has a particularly concerning incidence of cervical cancer where it ranks first as the leading cause of cancer in females. Screening is a reliable strategy to detect cervical cancer but implementation of screening in Papua New Guinea is poor. The aim of this review is to identify the enablers and barriers for cervical cancer screening in Papua New Guinea. Methods: A systematic search of peer-reviewed literature was conducted using electronic databases; PubMed, Medline, Scopus, CINAHL and Google Scholar. Articles published between 2007 and 2017 that focused on the enablers and barriers to cervical cancer screening were included. Only one study from Papua New Guinea was identified so the search was extended to include other Pacific Island Countries and Low-Income Countries more broadly. Findings: Twenty articles met the inclusion criteria. The main barriers for cervical cancer screening included a lack of women’s knowledge about cervical cancer and screening, a lack of health facilities for screening, diagnosis and treatment, lack of health care worker knowledge and training, cultural beliefs and financial burdens. The main enablers included women having access to education programs, availability of cervical cancer screening services, female friendly environments and health care workers being trained to undertake screening. Conclusions: While the literature highlighted the importance of cervical cancer screening, a range of barriers limits the delivery of this service in low-income country settings.  In particular, there is a gap in the knowledge of barriers and enablers within Papua New Guinea and further research in this country is required. Applying the knowledge learned from other low-income countries and gaining a clearer understanding of both the barriers and enablers for cervical cancer screening in the Papua New Guinea context may lead to clear recommendations to improve implementation and uptake of cervical cancer screening.


2021 ◽  
Vol 15 ◽  
Author(s):  
Chemtai Mungo ◽  
Emily Barker ◽  
Magdalene Randa ◽  
Jeniffer Ambaka ◽  
Cirilus Ogollah Osongo

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