Educational Interventions to Increase Cervical Cancer Screening Participation Among Women: A Systematic Review
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Abstract
Background: One of the most effective strategies for preventing cervical cancer is screening. In developing countries, the implementation and utilization of cervical cancer screening programs remain low. Educational interventions represent one strategy to increase participation in cervical cancer screening. Objective: This review aimed to identify educational interventions used to increase participation in cervical cancer screening. Methods: The inclusion criteria comprised studies that employed educational interventions to increase participation in cervical cancer screening. Literature searches were conducted in three databases—PubMed, Scopus, and ProQuest—and one search engine, ScienceDirect, for publications from 2020 to 2025. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Randomized Controlled Trials (RCTs). Results: A total of 10 studies involving 3,882 women who participated in educational interventions for cervical cancer screening were included. All included studies reported that educational interventions—delivered through face-to-face or digital approaches, and based on behavioral theories, community-based education, and couple-based education—were associated with improvements in knowledge, attitudes, risk perception, self-efficacy, and participation in cervical cancer screening. Based on the JBI Critical Appraisal Checklist for RCTs, most studies demonstrated moderate to high methodological quality. Conclusion: Couple-based education and counselling demonstrate high potential for implementation in Indonesia. This educational approach may help address cultural barriers and limited family support, which are known to hinder participation in cervical cancer screening.
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References
WHO. Cervical Cancer. World Heal Organ 2024.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71:209–49. https://doi.org/10.3322/caac.21660. DOI: https://doi.org/10.3322/caac.21660
WHO. WHO, UNFPA Commend Indonesia’s Efforts To Eliminate Cervical Cancer, Urge Streamlined Vaccine Strategy And Enhanced Screening. World Heal Organ 2024.
Abughazaleh S, Tarawneh M, Alzghoul H, Alsakarneh S, Saleh O, Mir WAY. A case report of lung metastasis in a cervical cancer presenting as a consolidation. Radiol Case Reports 2024;19:1144–8. https://doi.org/10.1016/j.radcr.2023.11.054. DOI: https://doi.org/10.1016/j.radcr.2023.11.054
Bedell SL, Goldstein LS, Goldstein AR, Goldstein AT. Cervical Cancer Screening: Past, Present, and Future. Sex Med Rev 2020;8:28–37. https://doi.org/10.1016/j.sxmr.2019.09.005. DOI: https://doi.org/10.1016/j.sxmr.2019.09.005
Muthuramalingam MR, Muraleedharan VR. Patterns in the prevalence and wealth-based inequality of cervical cancer screening in India. BMC Womens Health 2023;23. https://doi.org/10.1186/s12905-023-02504-y. DOI: https://doi.org/10.1186/s12905-023-02504-y
Ba DM, Ssentongo P, Musa J, Agbese E, Diakite B, Traore CB, et al. Prevalence and determinants of cervical cancer screening in five sub-Saharan African countries: A population-based study. Cancer Epidemiol 2021;72. https://doi.org/10.1016/j.canep.2021.101930. DOI: https://doi.org/10.1016/j.canep.2021.101930
Okyere J, Duodu PA, Aduse-Poku L, Agbadi P, Nutor JJ. Cervical cancer screening prevalence and its correlates in Cameroon: secondary data analysis of the 2018 demographic and health surveys. BMC Public Health 2021;21. https://doi.org/10.1186/s12889-021-11024-z. DOI: https://doi.org/10.1186/s12889-021-11024-z
Dirirsa DE, Asefa EY, Awol Salo M. Utilization of cervical cancer screening service and associated factors among women of reproductive age group in Ilu Abba Bor zone, southwestern Ethiopia, 2019: Cross-sectional study. SAGE Open Med 2022;10. https://doi.org/10.1177/20503121221094904. DOI: https://doi.org/10.1177/20503121221094904
Urquhart G, Maclennan SJ, Guntupalli AM. Is there an association between intimate partner violence and the prevalence of cervical cancer screening in Jordan? PLoS One 2023;18. https://doi.org/10.1371/journal.pone.0290678. DOI: https://doi.org/10.1371/journal.pone.0290678
Khan MJ, Kannan P, Sayma, Winser SJ. Population-based cross-sectional survey of cervical cancer screening prevalence and socio-demographic correlates in Bangladeshi women. Res Heal Serv Reg 2024;3. https://doi.org/10.1007/s43999-024-00053-x. DOI: https://doi.org/10.1007/s43999-024-00053-x
Kementerian Kesehatan. Survei Kesehatan Indonesia (SKI). Badan Kebijak Pembang Kesehatan, Kemenkes RI 2023.
Han X, Song G, Li Y, Dong Z, Yan X, Wang S, et al. Prevalence and genotype distribution of human papillomavirus infection among women aged 30–65 years in Xi’an, China: a population-based study of 14,655 women. Hum Vaccines Immunother 2021;17:5439–46. https://doi.org/10.1080/21645515.2021.2007709. DOI: https://doi.org/10.1080/21645515.2021.2007709
Ayanto SY, Belachew Lema T, Wordofa MA. Women’s and health professionals’ perceptions, beliefs and barriers to cervical cancer screening uptake in Southern Ethiopia: a qualitative study. Sex Reprod Heal Matters 2023;31:1–14. https://doi.org/10.1080/26410397.2023.2258477. DOI: https://doi.org/10.1080/26410397.2023.2258477
Abera GB, Abebe SM, Worku AG. Impact of health education intervention on demand of women for cervical cancer screening: a cluster-randomized controlled trial. Trials 2022;23. https://doi.org/10.1186/s13063-022-06765-0. DOI: https://doi.org/10.1186/s13063-022-06765-0
Ayanto SY, Belachew T, Wordofa MA. Effectiveness of couple education and counseling on uptake of cervical cancer screening among women in Southern Ethiopia: a cluster randomized trial. Sci Rep 2024;14. https://doi.org/10.1038/S41598-024-61988-2. DOI: https://doi.org/10.1038/s41598-024-61988-2
Mohammad Z, Ahmad N, Baharom A. The Effects of Theory-Based Educational Intervention and WhatsApp Follow-up on Papanicolaou Smear Uptake Among Postnatal Women in Malaysia: Randomized Controlled Trial. Jmir Mhealth Uhealth 2022;10:Article e32089. https://doi.org/10.2196/32089. DOI: https://doi.org/10.2196/32089
Wagner GJ, Matovu JKB, Juncker M, Namisango E, Bouskill K, Nakami S, et al. Effects of a peer advocacy intervention on cervical cancer screening among social network members: results of a randomized controlled trial in Uganda. J Behav Med 2023;46:930–9. https://doi.org/10.1007/s10865-023-00418-6. DOI: https://doi.org/10.1007/s10865-023-00418-6
Popay J, Roberts H SA. Guidance on the Conduct of Narrative Synthesis in Systematic Reviews: A Product From the ESRC Methods Programme. 2006.
Chandler J, Cumpston M, Li T, Page MJ W V. Cochrane Handbook for Systematic Reviews of Interventions. Hoboken: NJ: Wiley; 2019.
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med 2009;6. DOI: https://doi.org/10.2427/5768
Alyafei; A, Easton-Carr R. The Health Belief Model of Behavior Change. StatPearls [Internet] 2024.
Olubodun T, Balogun MR, Odeyemi AK, Odukoya OO, Ogunyemi AO, Kanma-Okafor OJ, et al. Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study. BMC Public Health 2022;22:1–10. https://doi.org/10.1186/s12889-022-14314-2. DOI: https://doi.org/10.1186/s12889-022-14314-2
Rizvi DS. Health education and global health: Practices, applications, and future research. J Educ Health Promot 2022;11:262. DOI: https://doi.org/10.4103/jehp.jehp_218_22
Husna N, Asfeni, Tobing VY. Pengaruh Pendidikan Kesehatan terhadap Sikap Mengenai Deteksi Dini Kanker Serviks. J Cakrawala Promkes 2020;2:73–9. DOI: https://doi.org/10.12928/promkes.v2i2.1712
Okunade KS, Soibi-Harry A, John-Olabode S, Adejimi AA, Allsop MJ, Onyeka TC, et al. Impact of Mobile Technologies on Cervical Cancer Screening Practices in Lagos, Nigeria (mHealth-Cervix): A Randomized Controlled Trial. JCO Glob Oncol 2021;7:1418–25. https://doi.org/10.1200/GO.21.00258. DOI: https://doi.org/10.1200/GO.21.00258
Wong C, So W, Chan D. Community health worker–led multimediaintervention to increase cervical cancer screeninguptake among South Asians: a randomisedcontrolled trial (abridged secondary publication). Hong Kong Med J 2024:39–42.
Han HR, Lee YJ, Min D, Chepkorir J, Hwang DSA, Chae S. Web-Based Delivery of an Effective Church-Based Intervention Program to Promote Cancer Screening (Community-based Health litEracy-focused intervention for breast and cervical Cancer Control) Among Korean Immigrant Women in the United States: Randomized Controlled Trial. JMIR Hum Factors 2025;12. https://doi.org/10.2196/66092. DOI: https://doi.org/10.2196/66092
Bahrami A, Rahimzadeh M, Safari-Moradabadi A. The impact of theory-based educational interventions: A three-arm randomized controlled trial comparing face-to-face, mobile-based, and control approaches on pap smear acceptance. Prev Med Reports 2025;57:Article 103198. https://doi.org/10.1016/j.pmedr.2025.103198. DOI: https://doi.org/10.1016/j.pmedr.2025.103198
Maleki A, Ahadinezhad B, Alizadeh A, Khosravizadeh O. Using a social marketing approach to increase the pap-smear test uptake : randomized controlled trial among women residing in urban region. BMC Womens Health 2025;25:1–11. DOI: https://doi.org/10.1186/s12905-025-03642-1
Hamdiui N, Stein ML, van Steenbergen J, Crutzen R, Bouman M, Khan A, et al. Evaluation of a Web-Based Culturally Sensitive Educational Video to Facilitate Informed Cervical Cancer Screening Decisions Among Turkish- and Moroccan-Dutch Women Aged 30 to 60 Years: Randomized Intervention Study. J Med Internet Res 2022;24:e35962. https://doi.org/10.2196/35962. DOI: https://doi.org/10.2196/35962
Degirmenci S, Erkal Aksoy Y. Effects of hand massage on women’s pain, comfort levels and flatulence times after caesarean section: A randomized controlled study. Adv Integr Med 2024. https://doi.org/10.1016/j.aimed.2024.09.001. DOI: https://doi.org/10.1016/j.aimed.2024.09.001