Delayed cervical cancer diagnosis: a systematic review

OBJECTIVE: Cervical cancer (CC) is a preventable women's cancer. Vaccination and routine Pap smear screening have reduced cervical cancer-related mortality by 70-80% in the world. The eradication of CC depends on identify-ing the disease early and removing barriers to its timely detection. This review study was designed to determine diagnostic delay and factors related to delayed CC diagnosis in the world.MATERIALS AND METHODS: A comprehen-sive search was carried out in databases includ-ing Medline, Web of Science, Core Collection (Indexes = SCI-EXPANDED, SSCI, A & HCI Time -span), and Scopus for articles published up to December 2021. Publications were included if they reported data on the delayed CC, and fac-tors related to diagnosis of CC in women. There was no time restriction in this review.RESULTS: In total, 45 articles were entered in-to the study. In studies, advanced stages of CC (IIB to IV) varied from 10.2% to 87.9% due to de-layed diagnosis. A delayed CC diagnosis was reported in 4.3%-89.1% of patients. The medi-an and mean days of delayed diagnosis were 59-210 days and 2.92-10.5 months, respective-ly. Factors related to delayed CC diagnosis were categorized into three components including pa-tient, medical history, and health system delay. Patient delay included socio-demographic, hus-band/ partner, and knowledge. Medical history included medical issues, obstetrics, and family history. Health system delays included health fa-cilities and levels of accessibility.CONCLUSIONS: There is an urgent need to shorten the diagnostic journey of CC patients by addressing all the components of diagnostic de-lay and developing strategies to modify the fac-tors associated with these delays.