Conclusion
Our results were encouraging regarding potential solutions for improving cervical cancer screening uptake. While some barriers such as fear of cancer diagnosis or longstanding cultural beliefs are difficult to address, other barriers offer feasible solutions. Younger women may have less control in their lives regarding transportation and scheduling, particularly when coordinating with parents, babysitting siblings, or school schedules. It was remarkable how many small changes, such as written reminders, pamphlets, or linking screening with other appointments, were noted to act as facilitators. In addition, multiple misconceptions about cervical cancer screening still persist, such as the belief that screening is only required if a patient is experiencing symptoms. Our studies suggested the effectiveness of awareness campaigns that are specifically aimed at younger people. Campaigns targeting the parents of younger girls, particularly mothers, may also be important as studies noted that parental support was a facilitator for screening.
Through addressing the above barriers and facilitators, health systems worldwide can hopefully address the much-touted goal of zero preventable deaths from cervical cancer. Young women who undergo screening are more likely to continue the practice as a lifelong habit as well as later recommend the practice to their children and peers.8-11 As such, every young woman who is screened offers a chance of strengthening a community around women’s health. Women who undergo cervical screening are also more likely to later espouse positive beliefs about the health system, sex-positive beliefs, and regain empowerment regarding their health.60,61
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. Health systems worldwide should address the above barriers and facilitators to increase cervical cancer screening rates in young women.
Acknowledgements : None
Disclosure of interests: None to disclose