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. 2025 Jun 2;25(1):2034.
doi: 10.1186/s12889-025-23118-z.

Sociocultural factors influencing women's adherence to colorectal, breast, and cervical cancer screening: a systematic review

Ghaneshinee Sathiyaseelan  1 , Syahnaz Mohd Hashim  2 , Azmawati Mohammed Nawi  3
Affiliations

Sociocultural factors influencing women's adherence to colorectal, breast, and cervical cancer screening: a systematic review

Ghaneshinee Sathiyaseelan et al. BMC Public Health. .

Abstract

Background: Cancer remains a leading cause of death among women globally, with breast, colorectal, and cervical cancers being the most prevalent. Despite established screening programs, low adherence rates persist, contributing to the continued high incidence of these cancers. Among the many influencing factors, sociocultural beliefs play a significant role in shaping women's health behaviours, often resulting in poor participation in screening initiatives. This systematic review aims to provide a thorough analysis of the impact of sociocultural factors on women's adherence to breast, colorectal, and cervical cancer screening.

Methods: This review focused on the influence of sociocultural belief factors on cancer screening adherence among women, hence PRISMA checklist was used, and the study was registered with PROSPERO. A systematic search of PubMed, Scopus, and Web of Science databases without any time limit and after applying strict inclusion and exclusion criteria, 53 studies were selected for detailed review. Then, the quality of these studies was evaluated using the Mixed-Method Appraisal Tool, and all the studies were classified as low risk of bias and included for data extraction.

Results: Most studies included were quantitative, conducted in high-income countries between 2015 and 2024, primarily focusing on cervical cancer. Actual participation in cancer screening was more often measured than intentions toward adhering to screening program with individual-based theories were often used in the selected studies. In total, nine sociocultural themes were identified and clustered using the Health Belief Model and the Socioecological Model into five main themes and six key sub-themes. The factors emerging from the sub-themes of the theory were reported as the primary factors, which were further divided into key individual-level factors such as fear, worry, spirituality, medical mistrust, and fatalism, alongside influential factors from family and surrounding level factors.

Conclusion: The review underscores that both individual-level factors, as conceptualised by the Health Belief Model, and broader contextual factors, as outlined by the Socioecological Model, play critical roles in influencing women's adherence to cancer screening. Cultural variations introduce unique sociocultural beliefs that may affect the generalisability of these findings. To improve adherence, interventions must address factors at multiple levels, ensuring a holistic approach to enhancing cancer screening programs.

Trial registration: The review protocol was registered using the PROSPERO International Prospective Register of Systematic Reviews and Meta-Analysis (ID = CRD 42024525634).

Keywords: Breast Cancer; Cancer Screening Program; Cervical Cancer; Colorectal Cancer; Compliance; Pre-malignant Female; Sociocultural Belief Factors.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval for this study was obtained from the Research and Ethics Committee UKM with an ethical reference number of JE—2023–827. The study was conducted in accordance with the Declaration of Helsinki; however, consent for participants is not applicable as no direct human subjects were involved. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram for new systematic reviews that included searches of databases
See this image and copyright information in PMC

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