Abstract 48: Health System Strategies to Improve the Uptake of Cervical Cancer Screening in Sub-Saharan Africa: A Scoping Systematic Review

Abstract Purpose: Globally, Sub-Saharan Africa (SSA) has the highest rate of cervical cancer incidence and mortality. Cervical cancer screening (CCS) is essential for identifying and treating pre-cancer and early- stage cervical cancer. However, CCS rates throughout SSA are substantially low due to a multitude of health system barriers, including poor access to CCS services, and limited skilled providers or supplies. The aim of this scoping review was to identify health system level strategies addressing barriers to implementing CCS in SSA. Methods: A systematic literature search was conducted across multiple databases, including PubMed and EMBASE, published in English from January 2010 to March 2024. The article review process involved independent screening by three trained research team members using Covidence software. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Results: The systematic search returned 4,682 articles, of which 42 were included in the final analysis. The studies were conducted in 17 SSA countries. Most effective implementation strategies included offering women the option of human papillomavirus (HPV) self-collection, single-visit CCS and treatment, providing CCS services at non-clinical community settings, training non-clinical providers to deliver CCS via task-sharing, and integrating CCS into existing non-primary care or gynecologic settings such as HIV screening clinics. Conclusion: We identified successful strategies to address health system barriers to CCS in SSA. Healthcare systems should consider implementing these strategies to maximize the outcome of reaching the World Health Organization’s cervical cancer elimination goal of screening 70% of women. Citation Format: Daniela Rivero-Mendoza, Klea Gjoka, Lashmi Singh, Lauren Adkins, Carma Bylund, Stephanie Staras, Ramzi Salloum, Elizabeth Shenkman, Rahma Mkuu. Health System Strategies to Improve the Uptake of Cervical Cancer Screening in Sub-Saharan Africa: A Scoping Systematic Review [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 48.