Interventions in Primary Care to Improve Cervical Cancer Screening: A Systematic Review

Cervical cancer screening is a vital preventive service commonly delivered within primary care, yet participation remains suboptimal, particularly among underserved or hard-to-reach groups. This systematic review evaluated the effectiveness of interventions implemented in primary care settings to improve screening uptake, knowledge, and related outcomes. A comprehensive search across major databases identified studies assessing interventions designed to increase screening participation within primary care or family medicine. Ten studies met the inclusion criteria, featuring approaches such as mailed and telephone reminders, short message service (SMS) outreach, multimodal contact strategies, digital educational tools, provider-directed prompts, and human papillomavirus (HPV) self-sampling. Reminder-based interventions consistently increased attendance, with telephone and multimodal outreach showing the greatest gains. Digital tools enhanced patient knowledge and communication, while HPV self-sampling yielded the largest improvements in screening uptake, particularly among Indigenous, long-overdue, and other underserved groups. Culturally tailored strategies produced modest but meaningful benefits for marginalized populations. Overall, randomized studies demonstrated acceptable methodological quality, while observational designs showed moderate to serious concerns. The evidence indicates that multimodal reminders, digital education, and HPV self-sampling are effective components of primary care-based efforts to improve cervical cancer screening, and integrating culturally responsive approaches may help address persistent disparities.