Hossain Md Anwer, Khanam Shimlin Jahan, Khan Md Nuruzzaman, Oldroyd John, Islam Rakibul M
Laboratory of Fertility and Well-Being, Max Planck Institute for Demographic Research, Rostock, Germany.
School of Geography and Sustainable Development, University of St Andrews, St Andrews, United Kingdom.
PLOS Glob Public Health. 2025 Mar 18;5(3):e0004225. doi: 10.1371/journal.pgph.0004225. eCollection 2025.
Cervical cancer disproportionately affects vulnerable populations including refugee women. Understanding the barriers to cervical cancer screening uptake in this group is crucial to inform targeted interventions and improve health outcomes. This review aimed to identify barriers hindering their access to cervical cancer screening. Five databases - Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, and SCOPUS - were searched in December 2024. The inclusion criteria included studies - a) targeting healthy refugee women, b) conducted in community or hospital/clinic settings, c) reporting barriers to cervical cancer screening from the women's perspective, and d) published in English. Thematic analysis was performed to identify the barriers. The review followed the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eleven studies, seven from the USA, one from each of the UK, Australia, South Korea and Jordan, were included in this review. Of these, six were qualitative, three were quantitative and two were mixed methods studies. There was a consistent pattern of lack of knowledge about cervical cancer and cancer screening in refugee women. A unique barrier was women's negative experiences in refugee camps. Four interconnected themes emerged including 1) individual level barriers, 2) cultural and religious barriers, 3) social and structural barriers, and 4) healthcare system barriers. Ninety percent of included studies were assessed as medium or high quality. The findings underscore the urgent need for targeted interventions to address the diverse challenges faced by refugee women globally which hinder their access to cervical cancer screening. Strategies should include culturally sensitive awareness campaigns, active engagement of healthcare professionals, and structural reforms within healthcare systems to enhance cervical cancer screening uptake among refugee women.
宫颈癌对包括难民妇女在内的弱势群体影响尤为严重。了解该群体接受宫颈癌筛查的障碍对于制定有针对性的干预措施和改善健康结果至关重要。本综述旨在确定阻碍她们获得宫颈癌筛查的障碍。2024年12月，检索了五个数据库——Ovid MEDLINE、EMBASE、PsycINFO、CINAHL和SCOPUS。纳入标准包括：a）针对健康难民妇女的研究；b）在社区或医院/诊所环境中开展的研究；c）从妇女角度报告宫颈癌筛查障碍的研究；d）以英文发表的研究。进行主题分析以确定障碍。本综述遵循了最新的系统评价和Meta分析首选报告项目（PRISMA）指南。本综述纳入了11项研究，其中7项来自美国，英国、澳大利亚、韩国和约旦各1项。其中，6项为定性研究，3项为定量研究，2项为混合方法研究。难民妇女对宫颈癌和癌症筛查缺乏了解是一种普遍现象。一个独特的障碍是妇女在难民营中的负面经历。出现了四个相互关联的主题，包括1）个人层面的障碍；2）文化和宗教障碍；3）社会和结构障碍；4）医疗系统障碍。纳入研究的90%被评估为中等或高质量。研究结果强调迫切需要采取有针对性的干预措施，以应对全球难民妇女面临的各种挑战，这些挑战阻碍了她们获得宫颈癌筛查。策略应包括开展具有文化敏感性的宣传活动、医护人员的积极参与以及医疗系统内部的结构改革，以提高难民妇女的宫颈癌筛查接受率。
