Factors Influencing the Experience of Breast and Cervical Cancer Screening Among Women in Low- and Middle-Income Countries: A Systematic Review

Abstract

PURPOSE The persistent high morbidity and mortality from breast and cervical cancer in low- and middle-income countries (LMICs) may be influenced by global disparities in the uptake of screening services. This review sought to synthesize existing evidence to determine factors that influence the experience of women relating to breast and cervical screening in LMICs. METHODS A qualitative systematic review of the literature identified through Global Health, Embase, PsycInfo, and MEDLINE. Eligible studies included those outlining primary qualitative research or mixed-method studies with reporting of qualitative findings, detailing women's experiences of involvement with programs for breast or cervical cancer screening. Framework synthesis was used to explore and organize findings from primary qualitative studies and the Critical Appraisal Skills Programme checklist used for quality assessment. RESULTS Database searches yielded 7,264 studies for title and abstract screening and 90 full-text articles for screening, with qualitative data from 17 studies and a total of 722 participants included in this review. Four stages influencing experiences of women were generated across both breast and cervical cancer screening approaches, with individual (eg, knowledge of cancer), social (eg, religion, cultural beliefs), and health system (eg, accessibility) factors identified that influence women's initial and subsequent engagement. CONCLUSION This study synthesizes existing evidence of factors that influence engagement with breast and cervical cancer screening in LMICs. Evidence-informed recommendations are proposed that may improve the experience of cancer screening in LMICs, with further research necessary to explore their operationalization and impact on cancer care delivery.

The Effect of Perceived Social support on Cervical Cancer Screening among Nepali women residing in Dhulikhel and Banepa municipality

“…Our results are similar to results from a systematic review written by Akoto, Edem J., and Matthew J. Allsop. [39] Diminished support from a spouse can reduce the likelihood of engagement with screening. [40][41] The influence of a spouse extends to financial and emotional support, often sought from preparation through to treatment and follow-up stages.…”

Patients’ experiences undergoing breast evaluation in Rwanda’s Women’s Cancer Early Detection Program

“…Further, our study addresses an important gap in the literature; a recent systematic review of factors in uencing women's experiences of breast and cervical cancer screenings in LMICs included just one study on the experiences of women undergoing breast cancer screening. [14] Thus, we believe that, in addition to informing the WCEDP, our ndings have value for guiding development and evaluation of breast cancer early detection programs in other resourceconstrained settings [26,27] and can inform global efforts such as the WHO Global Breast Cancer Initiative. [28] Participants identi ed facilitators of initial breast evaluation which suggest opportunities to strengthen the WCEDP and other early detection programs.…”

“…However, few studies have explored patients' experiences with breast cancer early detection initiatives in LMICs. [13,14] In addition, although extensive literature examines patients' experiences of false-positive mammograms in high-income settings, [15] there are no studies to our knowledge that explore patients' experiences with with false positive CBE. To address this gap and understand patients' perceptions of barriers to and facilitators of timely breast health care in the WCEDP, we conducted semistructured interviews with patients.…”

Cost-utility and budget impact analyses of cervical cancer screening using self-collected samples for HPV DNA testing in Thailand

“…The screening rate in the United States exceeds 80% among eligible women [ 1 ]. In comparison, low rates have been reported in many low- and middle-income countries [ 7 ]. The maximum adequate screening rate (i.e., screening at least once in 3 years) in Thailand has reached only approximately 40% [ 5 ].…”