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SYSTEMATIC REVIEW article

Front. Oncol.

Sec. Cancer Epidemiology and Prevention

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1575820

Barriers to cancer screening uptake and approaches to overcome them: A systematic literature review

Provisionally accepted
Raquel  Aguiar-IbanezRaquel Aguiar-Ibanez1*Yves Paul  Vincent MbousYves Paul Vincent Mbous2Sugandh  SharmaSugandh Sharma3Ravi  ChakaliRavi Chakali3Evanka  ChawlaEvanka Chawla3
  • 1Merck (Canada), Kirkland, Canada
  • 2Merck (United States), Kenilworth, New Jersey, United States
  • 3PAREXEL International (Hyderabad), TELANGANA, Telangana, India

The final, formatted version of the article will be published soon.

IntroductionCancer screening programs play a crucial role in early detection, improving survival rates and reducing the burden of advanced cancer. However, uptake remains inconsistent due to multifaceted barriers. This systematic review aimed to identify factors that impact cancer screening uptake across multiple tumor types and interventions to overcome barriers to cancer screening uptake.MethodsA systematic literature review was conducted using Embase® and MEDLINE® (May 2012 to May 2022) to identify observational studies that reported factors associated with screening uptake in adults, worldwide, with no tumor-specific restrictions. Records identified were screened by two independent reviewers. Included studies were data extracted by two reviewers and the results were reported narratively, focusing on identifying factors that acted as barriers or facilitators to cancer screening uptake, along with potential interventions to improve screening uptake.ResultsOverall, 811 studies were identified that reported factors influencing the uptake of screening programs, with 658 studies covering screening programs for breast, cervical, lung, colorectal, gastric and prostate cancers. Barriers to cancer screening included: being unmarried, experiencing higher deprivation, lower socioeconomic status and rural living conditions. Facilitators to cancer screening included: older age, poor perception of health, previous cancer history, family history of cancer, previous cancer screening history, having knowledge of the disease, positive attitudes to screening, perceived cancer risk, higher education level, having children, higher income, higher socioeconomic status, having health insurance, urban residence, having access to care, and recommendations for screening by primary care physicians. Mixed findings were identified for race and ethnicity, employment and smoking status. Targeted educational programs were the most suggested strategy to overcome barriers to cancer screening uptake.ConclusionBarriers to cancer screening across multiple tumor types are complex, spanning demographic and patient-level factors, social and economic factors, provider and community challenges, and access to health care. While certain barriers are shared across tumor types, others are unique, reflecting the specific requirements of screening for different tumors. Addressing these barriers requires multi-level strategies that integrate both universal and cancer-specific approaches. Targeted interventions and supportive policies can increase screening participation, facilitate earlier cancer diagnosis, and reduce disparities in cancer outcomes.

Keywords: Barriers1, cancer screening2, screening uptake3, facilitators4, screening intervention5, Public health6, preventative healthcare7

Received: 13 Feb 2025; Accepted: 30 Jun 2025.

Copyright: © 2025 Aguiar-Ibanez, Mbous, Sharma, Chakali and Chawla. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Raquel Aguiar-Ibanez, Merck (Canada), Kirkland, Canada

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