Barriers and facilitators to cervical cancer screening among Asian American women: a systematic review

Abstract

Objective: To understand barriers and facilitators for obtaining cervical cancer screening in Asian American women age > 18 years.Data Sources: A systematic review following PRISMA guidelines and using PubMed, EMBASE, and Web of Science to identify studies. Search terms included cervical cancer screening, Asian American, and Pap test. Additional studies identified manually.Study Selection: Only articles assessing sociodemographic, healthcare access, or acculturation factors and knowledge, attitudes, and behaviors in Asian American women associated with compliant and noncompliant cervical cancer screening behavior were included.Data Extraction: Extraction of data by 1 author using predefined data fields.Data Synthesis: A total of 17 articles met all inclusion criteria. Six groups were studied: Chinese, Filipina, Japanese, Korean, South Asian, and Vietnamese. Age, marital status, education, insurance coverage, time in the US, and English-speaking ability were associated with previous receipt of a Pap test. Young age, unmarried, uninsured, less time in the US and less than fluent English-speaking ability were less likely to have obtained a Pap test. Older age, married, private or public health insurance, more than ten years in the US, and fluent English-speaking ability were more likely to have obtained a Pap test. Variations of this trend were found among the subgroups. Not enough data on knowledge, attitudes, and behaviors to make generalizable statements.Interventions: Multi-component, community-based interventions using patient navigators, text messages, or lay health workers have varying degrees of success in increasing uptake of Pap tests but can bridge gaps in care and overcome barriers faced by Asian women seeking cervical cancer screenings.Limitations: Only applicable to the populations discussed. Not applicable to the entire Asian American community or other minority populations.Conclusion: Successful interventions to increase use of cervical cancer screenings must be targeted in their approach and demonstrate a thorough understanding of the characteristics of individual communities.

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