Barriers and Facilitators to Cervical Cancer Screening in Developing Countries

Background: Every year, approximately 250,000 women die of cervical cancer, a preventable disease. Nearly 90% of those deaths occur in developing countries. Incidence and mortality rates of cervical cancer in developed countries have decreased approximately 80% since the Pap smear was incorporated into the public health system and regular screening was recommended. The success of this system has not been experienced in developing countries and as a result, the burden of cervical cancer disproportionately affects women with the fewest resources to treat it.\ud Objectives: The primary aim of this thesis is to conduct a literature review to identify barriers and facilitators to cervical cancer screening in developing countries. Secondly, the researcher is an intern with the nonprofit organization, Basic Health International (BHI). In an effort to improve the low screening rates in El Salvador, one of the countries where BHI works, the researcher proposes a study to identify the barriers and facilitators to cervical cancer screening for women in rural El Salvador.\ud Methods: The researcher used the University of Pittsburgh Health Sciences Library including PubMed, and EBSCO to search for literature on this topic. Relevant articles included \ud those published between 1995 and 2012, addressing barriers and facilitators to cervical cancer screening in developing countries.\ud Results: Twenty-two articles were chosen for review based on the specified exclusion and inclusion criteria. The articles were analyzed using the Social Ecological Model and geographic region. The majority of the literature addressed individual level factors that affect screening behavior of women in developing countries.\ud Conclusions: The literature search revealed that there are multiple levels and channels through which public health professionals can intervene, while the individual level factors paint a picture of who is least likely to be screened. In looking forward, there is a possibility of targeting women for intervention using these profiles. Furthermore, the public health relevance of the literature search is that it emphasizes the role that culture plays on health behaviors, and the importance of identifying the barriers and facilitators to cervical cancer screening in a population.\u