Barriers to the uptake of cervical cancer screening methods in Low- and Middle-Income Countries (LMICs) – a scoping review using framework thematic analysis

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Abstract Background Cervical cancer remains a major cause of preventable death among women in low- and middle-income countries (LMICs). Despite the availability of effective screening, uptake remains low. Existing reviews have not fully captured the socio-cultural and behavioural barriers influencing women’s participation. This scoping review explores factors influencing the uptake of cervical cancer screening in women in LMICs. Method Qualitative studies exploring barriers and facilitators related to cervical cancer screening uptake were identified through a search of MEDLINE and Embase from January 2014 to December 2022. Qualitative data were extracted and analysed using framework thematic analysis guided by the Theoretical Domains Framework, and inductively coded to generate overarching themes. Results A total of 17 studies were included in the review. Knowledge, beliefs about consequences, social influences, social roles and emotions were identified as the key domains of barriers affecting screening uptake. Women in low- and middle-income countries held cultural values that were deeply important to them, which were closely intertwined with health education. Discrepancies between the perspectives of healthcare professionals and women’s cultural values contributed to a heightened mistrust of the healthcare system. Conclusion Lack of awareness about cervical cancer and misconceptions about its causes were prevalent, particularly in rural areas. Stigma, societal expectations, and gender inequalities further exacerbated the reluctance to access screening services, while procedural fears and distrust in healthcare providers deepened the problem. Trial registration PROSPERO registration: CRD42023402109.

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