Knowledge, cultural, and access barriers to cervical cancer screening among women aged 25 to 64

Main Article Content

Cecilia Lizeth Ibarra-Campos https://orcid.org/0009-0002-3529-155X
Alma Benita Lazcano-Castellanos https://orcid.org/0009-0007-2705-1894
Laura Patricia Limón-Toledo https://orcid.org/0000-0001-5852-2416
Ricardo Gutiérrez-Jauregui https://orcid.org/0009-0001-4224-7998
Diana Laura Franco-Curiel https://orcid.org/0009-0001-0775-4273

Keywords

Barriers to Acces of Health Services , Early Detection of Cancer, Uterine Cervical Neoplasms, Papanicolaou Test, Human Papilomavirus Viruses

Abstract

Introduction: Barriers to the timely detection of cervical cancer constitute a multidimensional phenomenon involving the interaction of factors related to knowledge, cultural beliefs, and access to health services.


Objective: To describe knowledge-related, cultural, and access barriers regarding the timely detection of cervical cancer among women aged 25 to 64 at a tertiary-care hospital in western Mexico.


Methodology: A descriptive cross-sectional study was conducted at a gynecology and obstetrics hospital. A total of 384 women were included using consecutive non-probability sampling. The "Barriers to Access for Cervical Cancer Screening Tests in Mexico" (BACACE) questionnaire was administered; it is structured around the dimensions of knowledge, cultural barriers, and access barriers (α = 0.71). Data were analyzed using descriptive statistics.


Results: Many participants possessed general knowledge regarding cervical cancer and the human papillomavirus (94.3%). The primary cultural barriers were fear (36.2%) and worry about an abnormal result (53.1%); regarding access, incompatible service hours (33.3%) were the most significant organizational obstacle.


Conclusion: Among women aged 25 to 64 receiving care at a tertiary-care hospital for the timely detection of cervical cancer, the main barriers identified relate to knowledge, culture, and access.

Abstract 0 | PDF (Spanish) Downloads 0

References

Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi:10.3322/caac.21834.

Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri: 2021 update. Int J Gynaecol Obstet. 2021;155(S1):28-44. doi:10.1002/ijgo.13865.

Brisson M, Kim JJ, Canfell K, et al. Impact of HPV vaccination and cervical screening on cervical cancer elimination: a comparative modelling analysis in 78 low-income and lower-middle-income countries. Lancet. 2020;395(10224):575-590. doi:10.1016/S0140-6736(20)30068-4.

Zou Z, Fairley CK, Ong JJ, et al. Impact of achieving WHO’s 90-70-90 targets on cervical cancer elimination and potential benefits in preventing other HPV-related cancers in China: a modelling study. EClinicalMedicine. 2024;77:102878. doi:10.1016/j.eclinm.2024.102878.

Canfell K, Kim JJ, Brisson M, et al. Mortality impact of achieving WHO cervical cancer elimination targets: a comparative modelling analysis in 78 low-income and lower-middle-income countries. Lancet. 2020;395(10224):591-603. doi:10.1016/S0140-6736(20)30157-4.

World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020.

Barquet-Muñoz SA, Arteaga-Gómez C, Díaz-López E, Rodríguez-Trejo A, Marquez-Acosta J, Aranda-Flores C. Current status and challenges in timely detection of cervical cancer in Mexico: expert consensus. Front Oncol. 2024;14. doi:10.3389/fonc.2024.1383105.

Rodríguez OAP, Galarde-López M, Sánchez CQ, Sevilla AR. Spatial Epidemiology of Human Papillomavirus Screening Coverage in Mexico, 2013-2019. Asian Pac J Cancer Prev. 2025;26(1):215-224. doi:10.31557/APJCP.2025.26.1.215.

Fernández-Deaza G, Serrano B, Roura E, et al. Cervical cancer screening coverage in the Americas region: a synthetic analysis. The Lancet Reg Health Am. 2024;30. doi:10.1016/j.lana.2024.100689.

Sharma J, Yennapu M, Priyanka Y. Screening Guidelines and Programs for Cervical Cancer Control in Countries of Different Economic Groups: A Narrative Review. Cureus. 2023;15(6):e41098. doi:10.7759/cureus.41098.

Fontham ETH, Wolf AMD, Church TR, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin. 2020;70(5):321-346. doi:10.3322/caac.21628.

León-Maldonado L, Cabral A, Pages G, et al. Barriers and facilitators to a combined strategy of HPV vaccination and cervical cancer screening among Mexican women. Hum Vaccin Immunother. 2025;21(1). doi:10.1080/21645515.2025.2483018.

Arrivillaga M, Bermúdez PC, García-Cifuentes JP, Rodríguez-López M, Neira D, Vargas-Cardona HD. Women’s critical experiences with the pap smear for the development of cervical cancer screening devices. Heliyon. 2023;9(3): e14289 doi:10.1016/j.heliyon.2023.

Matassini Eyzaguirre SM, Luna V. Barriers for diagnosis and therapy of cervical cancer in a public hospital in Lima, Peru: A qualitative study. Acta Med Peru. 2020;37(4):463-470. doi:10.35663/AMP.2020.374.1835.

Mosquera I, Barajas CB, Theriault H, et al. Assessment of barriers to cancer screening and interventions implemented to overcome these barriers in 27 countries in Latin American and Caribbean countries. Int J Cancer. 2024;155(4):719-730. doi:10.1002/ijc.34950.

Rivera-Chavarría A, Calderón-Céspedes A. Barriers according to health care access dimensions and cervical cancer in Costa Rica: a qualitative systematic review. Poblac Salud Mesoam. 2022;20(1). doi:10.15517/psm.v20i1.48983.

Petersen Z, Jaca A, Ginindza TG, et al. Barriers to uptake of cervical cancer screening services in low-and middle-income countries: a systematic review. BMC Womens Health. 2022;22(1). doi:10.1186/s12905-022-02043-y.

Morse RM, Brown J, Ríos López EJ, et al. Challenges associated with follow-up care after implementation of an HPV screen-and-treat program with ablative therapy for cervical cancer prevention. BMC Public Health. 2024;24(1). doi:10.1186/s12889-024-19436-3.

Gutiérrez Granados MM, Juárez Lira A. Desarrollo y validación de un instrumento en la determinación de barreras de acceso para pruebas de cribado de cáncer cervicouterino en México. Rev Cient de Enferm. 2021;(21):4-21. doi:10.14198/recien.2021.21.02.

Kedar A, John A, Goala S, et al. Barriers and facilitators in implementing population based common cancer screening through community health workers. Ecancermedicalscience. 2021;15:1277. doi:10.3332/ECANCER.2021.

Aguilar-Linares G, Márquez-Serrano M, Meneses-Navarro S, et al. Barriers and facilitators for adherence to follow-up by HR-HPV-positive women with premalignant cervical lesions: a mixed-design study in Mexico. BMC Womens Health. 2024;24(1). doi:10.1186/s12905-024-03379-3.

Rojas-González EP. Analysis of health programs on cervical cancer in Mexico Análisis de los programas de salud sobre el cáncer cervicouterino en México. doi:10.5281/zenodo.14367077.