Strengths and Limitations
Strengths of our review include our systematic search of four databases
using broad search criteria to maximize findings. Studies were not
excluded by basis of date of publication, country of origin, or language
of origin. To capture the full breadth of explored research, conference
abstracts were included. Our two parallel reviewers had high inter-rater
agreement. We also included age ranges up to 35 years, based on what has
been completed in previous literature. Limitations include that this
review included qualitative studies that may have been limited by
selection and publication bias, particularly for lower-income countries
that may not be well-represented in academic research. In addition,
cervical cancer screening guidelines (e.g. age to start screening) may
differ depending on country, which may limit generalizability of
results. Survey and interview results may also be compromised by
reporting bias, if study participants are potentially embarrassed to
discuss barriers or facilitators. More rigorous and systematic research
with an equity-focused lens is recommended to generalize results to
different populations and obtain higher quality information.