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This systematic review analyzes screening barriers using an accessibility framework. PubMed, Mendeley, and Google Scholar were searched for English studies (quantitative, qualitative, mixed-methods) from 1 Jan 2016 to 31 May 2021. From 67 articles, barriers were classified via the 5A framework (approachability, acceptability, availability, affordability, appropriateness) with added awareness and angst dimensions. Key impediments include limited awareness, service cost, distance, embarrassment and fear, and cultural factors such as lack of spousal or family support. Policymakers should strengthen health-system confidence and evidence-based education to improve adherence to screening.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/barriers-to-cervical-cancer-and-breast-cancer-screening-uptake-in-low-and-middle-income-countries-a-systematic-review/379862/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/barriers-to-cervical-cancer-and-breast-cancer-screening-uptake-in-low-and-middle-income-countries-a-systematic-review/379862.png","ImageObject",300,407,{"name":92,"@type":93},"Ivy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-27","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main objective of the systematic review?","Question",{"text":112,"@type":113},"To systematically analyze barriers to breast and cervical cancer screening uptake in low- and middle-income countries using an accessibility framework.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were screening barriers categorized in the review?",{"text":117,"@type":113},"Barriers were classified using the 5A accessibility framework—approachability, acceptability, availability, affordability, and appropriateness—with two additional aspects: awareness and angst.",{"name":119,"@type":110,"acceptedAnswer":120},"What barriers were found to most commonly impede screening uptake?",{"text":121,"@type":113},"Fear of screening outcomes, limited knowledge, distance to screening clinics, embarrassment, lack of support or permission from husbands, and high screening costs were identified as common barriers.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},379862,1790470423,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":56,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},549758252649,"https://ap-avatar.wpscdn.com/avatar/8000253669c5317157?_k=1778319167496531819","Barriers to cervical cancer and breast cancer screening uptake in low-and middle-income countries: a systematic review  \nAnanth Srinath 1,2,* , Frits van Merode2,3 , Shyam Vasudeva Rao3,4 and Milena Pavlova 2  \n1 Department of Community Oncology, Sri Shankara National Centre for Cancer Prevention and Research, 1st Cross, Shankara Math Campus, Shankarapuram, Basavanagudi, Bengaluru, Karnataka 560004, India  \n2 Department of Health Services Research, Care and Public Health Research Institute, Maastricht University Medical Centre+, Maastricht University, P. O. Box 616, Maastricht, MD 6200, The Netherlands  \n3 Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre+, Maastricht University, P. Debyelaan 25, Maastricht, HX 6229, The Netherlands  \n4 Forus Health Private Limited, \\#2234, 23rd Cross, Banashankari 2nd Stage, Bengaluru, Karnataka 560070, India,  \n*Corresponding author. Department of Community Oncology, Sri Shankara National Centre for Cancer Prevention and Research, 1st Cross, Shankara Math  \nCampus, Shankarapuram, Basavanagudi, Bengaluru, Karnataka 560004, India. E-mail: [ananthsrinath@gmail.com](ananthsrinath@gmail.com)  \nAccepted on 16 December 2022  \nAbstract  \nThere is an alarmingly high growth in breast and cervical cancers in low-and middle-income countries. Due to late presentation to doctors, thereis a lower cure rate. The screening programmes in low- and middle-income countries are not comprehensive. In this paper, we systematically analyse the barriers to screening through an accessibility framework. We performed a systematic literature search in PubMed, Mendeley and Google Scholar to retrieve all English language studies (quantitative, qualitative and mixed-methods) that contained information on breast and cervical cancer screening in low-and middle-income countries. We only considered publications published between 1 January 2016 and 31 May 2021. The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension (PRISMA-S), an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. The search yielded a total of 67 articles from low- and middle-income countries in this review. We used a framework on accessibility known as the 5A framework, which distinguishes five aspects of access: approachability, acceptability, availability, affordability and appropriateness, to classify the screening barriers. We added two more aspects: awareness and angst, as they could explain other important barriers to screening. They confirmed how the lack of awareness, cost of the screening service and distance to the screening centre act as major impediments to screening. They also revealed how embarrassment and fear of screening and cultural factors such as lack of spousal or family support could be obstacles to screening. We conclude that more needs to be done by policymakers and governments to improve the confidence of the people in the health systems. Women should be made aware of the causes and risk factors of cancer through evidence-based strategies so that there is an increased adherence to screening. Keywords: Systematic literature review, barriers to breast and cervical screening, accessibility, low-and middle-income countries  \n\n| \u003Cbr>Key messages\u003Cbr>• Fear of screening test results, lack of knowledge about the disease and screening, distance to the screening clinic, embarrassment to undergo screening, lack of support or permission from husbands to undergo screening and high cost of screening were the most common barriers. Barriers to treatment and socio-cultural factors have a major influence on screening uptake.\u003Cbr>Introduction\u003Cbr>Every year, there are >2.26 million new breast cancer cases and >600 000 new cervical cancer cases worldwide. Over 91% of deaths from cervical cancer and >79% of deaths | from breast cancer occur in low- and middle-income countries (Globocan, 2020) . The incidence of both cancer ","cbCaivhU0yirGex0","https://ap.wps.com/l/cbCaivhU0yirGex0","pdf",553807,"English","# Abstract\n# Key messages\n# Introduction","[{\"question\":\"What was the main objective of the systematic review?\",\"answer\":\"To systematically analyze barriers to breast and cervical cancer screening uptake in low- and middle-income countries using an accessibility framework.\"},{\"question\":\"How were screening barriers categorized in the review?\",\"answer\":\"Barriers were classified using the 5A accessibility framework—approachability, acceptability, availability, affordability, and appropriateness—with two additional aspects: awareness and angst.\"},{\"question\":\"What barriers were found to most commonly impede screening uptake?\",\"answer\":\"Fear of screening outcomes, limited knowledge, distance to screening clinics, embarrassment, lack of support or permission from husbands, and high screening costs were identified as common barriers.\"}]","Barriers to cervical cancer and breast cancer screening uptake in low-and middle-income countries: a systematic review | PDF",1790237804,48]