Determinants of Routine Cervical Screening Participation in Underserved Women: A Qualitative Systematic Review

Angela Wearn*, Lee Shepherd

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)
150 Downloads (Pure)



Routine, population-wide cervical screening programmes reduce cervical cancer incidence and mortality. However, socioeconomically deprived communities and ethnic minority groups typically have lower uptake in comparison to the general population and thus are described as ‘underserved.’ A systematic qualitative literature review was conducted to identify relevant determinants of participation for these groups.


Online databases were searched for relevant literature from countries with well-established, call-recall screening programmes. Overall, 24 articles were eligible for inclusion. Data was synthesized via Framework synthesis. Dahlgren & Whitehead’s social model of health was used as a broad a priori coding framework.


Participation was influenced by determinants at multiple levels. Overall, patient-provider relationships and peer support facilitated engagement. Cultural disparities, past healthcare experience and practical barriers hindered service access and exacerbated negative thoughts, feelings and attitudes towards participation. Complex interrelationships between determinants suggest barriers have a cumulative effect on screening participation.


These findings present a framework of psychosocial determinants of cervical screening uptake in underserved women and emphasise the role of policy makers and practitioners in reducing structural barriers to screening services. Additional work, exploring the experience of those living within socioeconomically disadvantaged areas, is needed to strengthen understanding in this area.

Original languageEnglish
Pages (from-to)145-170
Number of pages26
JournalPsychology & Health
Issue number2
Early online date16 Mar 2022
Publication statusPublished - 1 Feb 2024


Dive into the research topics of 'Determinants of Routine Cervical Screening Participation in Underserved Women: A Qualitative Systematic Review'. Together they form a unique fingerprint.

Cite this