Strategies and Determinants Influencing Cervical Cancer Screening Participation: A Narrative Review of Global Evidence

Abstract

Background : Cervical cancer remains a leading cause of morbidity and mortality among women worldwide, particularly in low- and middle-income countries. Despite the availability of effective screening methods such as Pap smear and HPV testing, participation rates remain suboptimal due to various social, cultural, and systemic barriers. Objective : This study aims to identify effective strategies and key determinants influencing women’s participation in cervical cancer screening across diverse cultural and geographical contexts. Research Methods/ Implementation Methods : A narrative synthesis of 12 peer-reviewed articles published between 2018 and 2025 was conducted. Articles were selected based on relevance to cervical cancer screening, including randomized controlled trials, cross-sectional surveys, systematic reviews, and meta-analyses. Key themes were extracted and analyzed for trends, effectiveness of interventions, and associated factors Results : Educational interventions, including empowerment programs and narrative media approaches, significantly increased screening knowledge and participation (p < 0.05). Opt-out invitation systems and community-based outreach campaigns demonstrated higher uptake compared with routine invitations. However, substantial gaps persist, particularly among rural and low-income women, due to limited awareness, fear, and cultural stigma. Factors such as education, income, age, parity, and contraceptive use were consistently associated with screening participation. Conclusion/Lesson Learned : Integrated strategies combining education, community empowerment, and opt-out systems effectively enhance cervical cancer screening uptake. Addressing sociocultural and economic barriers through context-specific public health interventions is essential. Further longitudinal studies are needed to evaluate the sustainability of these approaches in improving screening behavior.