Introduction
Methods
Data sources and search strategy
Study selection
Data extraction and synthesis of results
Results
Sources of evidence
Characteristics of selected studies
Study | Year | Country | Study Type | Study population | Sample Size |
---|---|---|---|---|---|
Abdullahi et al. [37] | 2009 | England | Qualitative Focus Groups and Interviews | Migrant women (Somali) | Migrants: 50 |
Otero et al. [38] | 2011 | Spain | Qualitative Interviews | Healthcare providers (Midwives) | Healthcare providers: 10 |
Azerkan et al. [12] | 2012 | Sweden | Quantitative Longitudinal | Migrant women (Not specified) Native women | Total: 2,621,802 Migrants: 445,547 |
Jackowska et al. [39] | 2012 | England | Qualitative Focus Groups and Interviews | Migrant women (Polish, Romanian, and Slovak) Healthcare providers (Nurses, consultants, GP practice manager, gynecologist, and healthcare assistant) Stakeholders (Advocate working with migrants) | Migrant women: 42 Healthcare providers: 10 Stakeholders: 1 |
Rodríguez-Salés et al. [40] | 2013 | Spain | Quantitative Cross-sectional | Migrant women (Not specified) Native women | Total: 1,562,968 Migrants: 251,679 |
Olsson et al. [41] | 2014 | Sweden | Qualitative Focus Groups | Stakeholders (Doulas) | Stakeholders: 13 |
Azerkan et al. [42] | 2015 | Sweden | Qualitative Focus Groups | Migrant women (Danish and Norwegian) | Migrants: 40 |
Grandahl et al. [43] | 2015 | Sweden | Qualitative Focus Groups | Migrant women (Middle Eastern, African, Asian, and East European) | Migrants: 50 |
Akhagba [44] | 2017 | Poland | Qualitative Focus Groups | Migrant women (African) | Migrants: 12 |
Bianco et al. [45] | 2017 | Italy | Quantitative Cross-sectional | Migrant women (European, African, Asian, and American) | Migrants: 464 |
Comparetto et al. [46] | 2017 | Italy | Quantitative Cross-sectional | Migrant women (Not specified) Native Women | Total: 69,459 Migrants: 7339 |
Gallo et al. [47] | 2017 | Italy | Quantitative Longitudinal | Migrant Women (High income countries and low- and middle-income countries) Native women | Total: 1,610,855 Migrants: 227,061 |
Gele et al. [27] | 2017 | Norway | Qualitative Focus Groups | Migrant women (Pakistani and Somali) | Migrants: 35 |
Idehen et al. [48] | 2017 | Finland | Quantitative Cross-sectional | Migrant women (Russian, Somali, and Kurdish) | Migrants: 620 |
Møen et al. [49] | 2017 | Norway | Quantitative Cross-sectional | Migrant women (Western Europe, Eastern Europe, Asia, Africa, and South America) Native women | Total: 1,321,632 Migrants: 152,800 |
Addawe et al. [50] | 2018 | Norway | Qualitative Focus Groups and Interviews | Migrant women (Somali) | Migrants: 57 |
Idehen et al. [51] | 2018 | Finland | Quantitative Cross-sectional | Migrant women (Russian, Somali, and Kurdish) Native women | Total: 973 Migrants: 537 |
Møen et al. [52] | 2018 | Norway | Qualitative Focus Groups and Interviews | Healthcare providers (General practitioners, midwives, and gynecologists) | Healthcare providers: 33 |
Barrera-Castillo et al. [53] | 2019 | Spain | Quantitative Cross-sectional | Migrant women (Not specified) Native women | Total: 8944 Migrants: 886 |
Hertzum-Larsen et al. [54] | 2019 | Denmark | Quantitative Longitudinal | Migrant women (Western, and Nonwestern) Native women | Total: 610,907 Migrants: 57,329 |
Factors associated with cervical cancer screening participation
Barriers to CCS participation
Factors | Study | Participants’ country of origin |
---|---|---|
Sociodemographic | ||
Older age groups | [47] [46] [49] [40] | Low- and middle-income countries Not specified Eastern Europe Not Specified |
Younger age groups | [47] [49] [48] | High income countries Asia Russia |
Being unmarried | [47] [51] [54] [53] | Low- and middle-income countries Somalia Not specified Not specified |
Being married/cohabiting | [49] [51] [42] | Asia and South America Russia and Kurdistan Denmark and Norway |
Not having children | [48] [54] [42] | Kurdistan Not specified Denmark and Norway |
Having children | [42] | Denmark and Norway |
Low social support | [42] [53] [44] [41] | Denmark and Norway Not specified Africa Not Specified |
Low educational level | [47] [48] | Not specified Kurdistan |
Being unemployed | [51] [48] [54] | Russia and Kurdistan Kurdistan Not specified |
Being employed | [51] | Somalia |
No insurance | [53] [38] | Not specified Not specified |
Low socioeconomic status | [27] [49] [54] [38] [41] | Pakistan and Somalia Not specified Not specified Not specified Not Specified |
Very high socioeconomic status | [47] | Not specified |
Having a smaller household | [51] | Kurdistan |
Having a bigger household | [51] | Russia and Somalia |
Living in urban areas | [49] [51] | Not specified Russia and Kurdistan |
Living in rural areas | [51] [48] | Somalia Somalia |
Healthcare system | ||
Not having a female healthcare provider | [27] [49] [50] [37] [43] [52] | Pakistan and Somalia Not specified Somalia Somalia Not specified Not specified |
Not having a gynecologist doing the screening test | [52] [39] | Not specified Poland, Slovakia, Romania |
Perception of the screening as impersonal | [42] | Denmark and Norway |
Long waiting time in healthcare services | [42] [44] [39] | Denmark and Norway Africa Poland, Slovakia, Romania |
Lack of time and/or information from healthcare providers | [27] [52] | Not specified |
Poor hygiene in healthcare services | [39] | Poland, Slovakia, Romania |
Lack of access to healthcare services | [46] | Not specified |
Negative relationship with healthcare provider | [27] | Pakistan and Somalia |
Unprofessional healthcare providers | [42] [50] [39] | Denmark and Norway Somalia Poland, Slovakia, Romania |
Healthcare providers lack of skills to work with migrant women | [52] | Not specified |
Having a migrant healthcare provider | [49] | Western and Eastern Europe, Asia |
Unaccustomed to preventive healthcare | [43] [41] | Not specified Not Specified |
Lack of regular medical checkups | [48] [54] [41] | Russia, Somalia, Kurdistan Not specified Not Specified |
Psychological | ||
Fear of the screening test | [44] [37] [43] [52] [39] [41] | Africa Somalia Not specified Not specified Poland, Slovakia, Romania Not Specified |
Fear of the test result/fear of cancer | [42] [50] [37] [39] [41] | Denmark. Norway Somalia Somalia Poland, Slovakia, Romania Not Specified |
Emotional discomfort about the screening test | [42] [44] [50] [43] [39] [41] | Denmark, Norway Africa Somalia Not specified Poland, Slovakia, Romania Not Specified |
Fatalistic views about cancer | [50] [41] | Somalia Not Specified |
Lack of trust in healthcare services | [27] [50] [39] [41] | Pakistan, Somalia Somalia Poland, Slovakia, Romania Not Specified |
Negative past experiences in healthcare services | [27] [44] [37] [41] | Pakistan and Somalia Africa Somalia Not Specified |
Experiencing sexual assault | [42] | Denmark, Norway |
Experiencing female genital mutilation | [27] [50] | Somalia Somalia |
Other life priorities | [42] [37] [52] [41] | Denmark, Norway Somalia Not specified Not Specified |
Lack of time | [50] [37] [39] [41] | Somalia Somalia Poland, Slovakia, Romania Not Specified |
Migration-related | ||
Country of birth | [12] [47] [46] [40] [45] | Not specified Africa, Asia Not specified South-Central Asia, Western Europe, South-Eastern Asia, North America Not specified |
Short length of stay in the country | [49] [48] [54] [42] [39] [45] | Not specified Russia Not specified Denmark, Norway Poland, Slovakia, Romania Not specified |
Long length of stay in the country | [49] | Western Europe, Asia, Africa, South America |
Older age at migration | [12] | Not specified |
Re-immigration | [54] | Not specified |
Attending cervical cancer screening in home country | [44] [39] | Africa Poland, Slovakia, Romania |
Knowledge-related | ||
Lack of information about cervical cancer screening | [27] [44] [38] [50] [37] [43] [39] [41] | Pakistan, Somalia Africa Not specified Somalia Somalia Not specified Poland, Slovakia, Romania Not Specified |
Lack of information about cervical cancer | [27] [50] [43] | Pakistan, Somalia Somalia Not specified |
Low perceived need of screening | [42] [50] [37] | Denmark, Norway Somalia Somalia |
Lack of information regarding the healthcare services | [42] [38] [43] [39] | Denmark, Norway Not specified Not specified Poland, Slovakia, Romania |
Language-related | ||
Language difficulties | [27] [48] [44] [37] [52] [39] [41] | Pakistan, Somalia Russia Africa Somalia Not specified Poland, Slovakia, Romania Not Specified |
Family member/male interpreter during the screening test | [27] [52] | Pakistan, Somalia Not specified |
Not having an interpreter during the screening test | [37] [41] | Somalia Not Specified |
Cultural | ||
Cultural differences | [42] [39] | Denmark, Norway Poland, Slovakia, Romania |
Social stigma about women’s health | [43] [41] | Not specified Not Specified |
Religious beliefs | [27] [50] | Pakistan and Somalia Somalia |
Sociodemographic-related barriers
Healthcare system barriers
Psychological barriers
Migration-related barriers
Knowledge-related barriers
Language-related barriers
Cultural barriers
Facilitators of CCS participation
Facilitating factors | Study | Participants’ country of origin |
---|---|---|
Healthcare System | ||
Healthcare providers’ explanations and encouragement | [27] [50] [37] [52] [39] | Pakistan, Somalia Somalia Somalia Not specified Poland, Slovakia, Romania |
Having had a recent medical appointment | [46] [48] | Not specified Russia, Somalia, Kurdistan |
Good organization and promotion of screening programs | [38] [43] [39] | Not specified Not specified Poland, Slovakia, Romania |
Regular invitations to cervical cancer screening | [27] [42] [38] [39] | Pakistan. Somalia Denmark, Norway Not specified Poland, Slovakia, Romania |
Knowledge and language-related | ||
Providing information about cervical cancer and screening | [27] [50] [37] [39] | Pakistan, Somalia Somalia Somalia Poland, Slovakia, Romania |
Providing information leaflets/invitation letters in women’s mother languages | [27] [47] [50] [43] [39] | Pakistan, Somalia Not specified Somalia Not specified Poland, Slovakia, Romania |
Providing experienced interpreters | [27] [37] [52] | Pakistan, Somalia Somalia Not specified |
Collaboration with stakeholders to promote CCS | [37] [41] | Somalia Not Specified |
Cultural | ||
Dialogue about cultural issues | [50] [52] | Somalia Not specified |