Improving cervical cancer screening uptake through theory-informed education: a comprehensive systematic review and...

This study examined whether theory-based education increases cervical cancer screening among underserved women.

Seven databases (PubMed, Embase, Scopus, Web of Science, Cochrane Library, CINAHL, and PsycINFO) were systematically searched for studies published between January 2005 and November 2025. A total of 1,200 records were identified; after duplicate removal, 900 titles and abstracts were screened, and 200 full-text articles were assessed. Fourteen studies met inclusion criteria for qualitative synthesis, and 12 trials contributed extractable binary outcome data for meta-analysis, including one study with two distinct intervention arms. The primary outcome was screening uptake (Pap smear, visual inspection with acetic acid [VIA], or human papillomavirus [HPV] testing). Data extraction and quality appraisal followed PRISMA 2020 and Joanna Briggs Institute guidance. Pooled odds ratios (ORs) were calculated using DerSimonian-Laird random-effects models with Hartung-Knapp adjustment, and heterogeneity, prediction intervals, small-study effects, and certainty of evidence (GRADE) were evaluated.

Structured educational interventions significantly increased screening uptake compared with usual care or minimal information (OR = 4.41; 95% confidence interval [CI]: 2.21-8.80). Subgroup analyses showed substantial effects in both high-income (OR = 3.46; 95% CI: 1.43-8.36) and middle-income settings (OR = 6.55; 95% CI: 2.74-15.63). Interventions frequently incorporated behavioral frameworks, such as the Health Belief Model, Protection Motivation Theory, and BASNEF model, and were often culturally tailored or delivered through community-embedded formats.

Integrating such interventions into national and local screening programs represents an effective and equitable strategy to reduce disparities in cervical cancer prevention.