Review Article
Women’s preferences and experiences of cervical cancer screening in rural and remote areas: a systematic review and qualitative meta-synthesis
AUTHORS
Umair Majid1 MSc, MEd, Student/Research Assistant
Sujane Kandasamy2 MSc, Research Assistant/Student
Kelly Farrah3 MLIS, Information Specialist
Meredith Vanstone4 PhD, Assistant Professor *
AFFILIATIONS
1 Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. Present address: Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
2 Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
3 Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, Ontario, Canada
4 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada; and Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
ACCEPTED: 5 August 2019
early abstract:
Introduction: Cervical cancer is one of the leading causes of mortality in women. Population-based cervical cancer screening programs have been highly effective in reducing the incidence and mortality of cervical cancer worldwide. However, there still remain disparities in women’s cervical cancer screening participation rates, especially in rural and remote areas where access to health care may be circumscribed due to logistical barriers. Until now, there has been no effort to review and synthesize the perspectives and experiences of women accessing cervical cancer screening in rural and remote areas. This systematic review and qualitative meta-synthesis of 14 studies aims to describe and elaborate the issues women face when accessing cervical cancer screening in rural and remote areas.
Methods: This study used the qualitative meta-synthesis approach to review 14 studies on rural women participation in cervical cancer screening. This research approach synthesizes findings from multiple, primary qualitative studies to produce a new interpretation of the phenomenon while retaining the original meaning of each qualitative study.
Results: After screening through 4937 citations from database searching, 117 were retrieved for full-text review, of which 14 studies were included. This study identified two themes that modulate rural women’s access of cervical cancer screening: 1) interactions with health care providers and 2) health care system access. Furthermore, this study found that women frequently expressed issues around patient-centred care in their interactions with health care providers. The implications of these findings to program design and delivery efforts in rural and remote areas are discussed.
Conclusions: This article provides the foundation for tailoring interventions and programming to increase cervical cancer screening rates in women who reside in rural and remote areas. This review also clarifies the factors of patient-centred care that may be adopted to enhance the quality of care for women in rural and remote areas. In summary, this systematic review and qualitative meta-synthesis provides information about women’s perspectives and experiences accessing cervical cancer screening in rural and remote areas. This review has strong implications for this population and can be used to inform future research and program design initiatives.