OBJECTIVES: In Southeast Asia (SEA), cervical cancer is the second most common cancer in women. Low coverage for cervical cancer screening (CCS) becomes a roadblock to disease detection and treatment. Existing reviews on CCS have limited insights on the barriers and facilitators for SEA. Hence, this study aims to identify key barriers and facilitators among women living in SEA.

METHODS: A systematic literature review was conducted on Pubmed, Embase, PsycINFO, CINAHL and SCOPUS in November 2020 by two independent reviewers. Primary qualitative and quantitative studies published in English that reported barriers and facilitators to CCS were included. Interventional studies without baseline barrier or facilitator to CCS were excluded. Thematic analysis was performed to classify barriers and facilitators. The Mix Methods Appraisal Tool (MMAT) was used for quality assessment of included studies.

RESULTS: A total of 3025 records were identified, which yielded 93 studies for inclusion. Pap smears (73.1%) were the most common screening modality. Majority of the studies were from Malaysia (35.5%). No study was from Timor-Leste and Philippines. Majority of the studies (66.7%) scored 4 or 5 on the MMAT. Out of 11 countries in SEA, six reported barriers related to demographics, knowledge, risk perception and health system. Seven countries reported demographic related facilitators while six countries reported knowledge, financial access, and health system related facilitators. The most common barriers were embarrassment (n = 33), time constraints (n = 27), and poor knowledge of screening (n = 27). The most common facilitators were related to age (n = 21), having advice from health workers (n = 17) and education status (n = 11).

CONCLUSIONS: A significant number of barriers and facilitators affect the uptake of CCS in SEA. Findings from this review may inform health policy makers in developing effective cervical cancer screening programs in SEA countries.