Determinants of routine cervical screening participation in underserved women: a qualitative systematic review

A rapid review of barriers and facilitators to cancer screening uptake (breast, cervical and bowel) in underserved populations

“…The pre-pandemic literature used here for comparison was identified using a supplementary scoping search for published systematic reviews (see Section 5). Five systematic reviews (Baird et al, 2021, Travis et al, 2020, Wearn and Shepherd, 2022, Wessex Voices, 2021, Young et al, 2018) reporting pre-pandemic evidence on barriers and facilitators to breast, bowel, and cervical screening uptake in various underserved populations were identified. These reviews sought the barriers and facilitators among Black, Asian and minority ethnic (BAME) groups, low-uptake sociodemographic groups, people with mental illness or learning disabilities, people with physical disabilities, Lesbian, Gay, Bisexual and Trans (LGBT) people and underserved women.…”

“…Facilitators included sense of responsibility to use public funding and resources, presence of a professional throughout the procedure, family support and encouragement, doctor/physician screening recommendation, and personalised invitations from medical professionals. Wearn and Shepherd (2022) conducted a qualitative systematic review on the determinants of routine cervical screening participation in underserved women. Barriers to participation included embarrassment, fear of the test and potential outcome, risk beliefs, religious beliefs, prioritising competing demands, perceived stigma, lack of knowledge, peer and family influence, communication barriers, unfamiliarity with screening, negative past experiences of healthcare and screening, gender of practitioner, interpersonal skills of practitioner, medical mistrust, service accessibility, and cultural differences.…”

“…Prior research has reported low uptake of cancer screening programmes by individuals from socioeconomically deprived communities and among ethnic minority and underserved populations (Nardi et al, 2016, Ni et al, 2020, Szczepura et al, 2008). Higher rates of non- attendance in cancer screening programmes within these population groups are therefore likely to result in more cancer diagnoses and cancer related deaths within these already disadvantaged communities (Wearn and Shepherd, 2022). Underserved population groups have also been disproportionately impacted by the COVID-19 pandemic, which may lead to even wider inequalities in cancer screening uptake within these groups.…”

Physically fit with a higher cancer risk? Influences of cervical cancer screening among a sample of physically active women ages 21–49 living in the United States

“…This compares with previous research documenting participation in cancer-risk related behaviors among women engaging in sports and generally low cancer-risk related behavioral knowledge among young adults within this age range ( American Cancer Society. Cervical Cancer Causes, Risk Factors,and Prevention., 2021 , Gönenç, 2020 , Moore et al, 2013 , Mastroleo, 2013 , Martin, 2021 , Hingson, 2009 , Turrisi, 2006 , Nelson and Wechsler, 2001 , Nardi et al, 2016 , Christy, 2021 , Nolan, 2014 , Wearn and Shepherd, 2022 , Fuzzell, 2021 , Schrager et al, 2017 , Han, 2018 , Landy, 2016 ). Moreover, with half of our sample self-identifying as Black, reportedly low cervical cancer screening rates may be explained by previous research that suggests inadequate knowledge and perceived barriers as influential factors affecting the decision of minority women to not get screened for cervical cancer ( Nardi et al, 2016 ).…”

“…Yet, evidence suggests that Black women have low engagement in cervical cancer screening for reasons such as low insurance coverage, distrust of the health care system, fear of test results, and lack of transportation to health care service ( Nolan, 2014 ). Even when Black women have access to screening services, utilization remains low due to factors such as quality and experiences of care that fosters mistrust in the health care system ( Christy, 2021 , Wearn and Shepherd, 2022 ). Systemic racism also exposes Black women to discrimination while utilizing health care services, thereby influencing their uptake of the Pap test ( Fuzzell, 2021 ).…”