Table 1.
Characteristics of the included studies.
| Author (Year) | Country | Study Design/Instrument Used | Sample Size | Age of Participants (Years) | Type of Screening Methods Used | Prevalence of Ever Receiving Screening in the Past | MMAT Score |
|---|---|---|---|---|---|---|---|
| Suhaimi et al. (2020) [100] | Brunei | Cross-sectional/interview with structured questionnaire | 3808 (2131 females) |
Mean (SD): 41.9 (14.5) |
Pap smear | 56.5% | 5 |
| Touch et al. (2018) [101] | Cambodia | Cross-sectional/interview with structured questionnaire | 440 |
Distribution: 20–29: 88 (20.0%) 30–39: 88 (20.0%) 40–49: 88 (20.0%) 50–59: 88 (20.0%) 60–69: 88 (20.0%) |
Pap smear | 7.0% | 5 |
| Kim et al. (2012) [74] | Indonesia | Qualitative/interview and focus group discussion | 87 |
Range: 25–50 |
VIA | Unspecified | 5 |
| Anggraeni et al. (2016) [72] | Indonesia | Cross-sectional/survey questionnaire | 96 |
Distribution: <20 years: 2 (2.1%) 20–35 years: 44 (45.8%) >35 years: 50 (52.1%) |
Pap smear | 33.3% | 4 |
| Nurhasanah et al. (2017) [76] | Indonesia | Cross-sectional/unspecified | 176 |
Distribution: 20–29 years: 35 (19.9%) 30–39 years: 51 (29.0%) 40–49 years: 71 (40.3%) 50–59 years: 19 (10.8%) |
VIA | 33.0% | 3 |
| Sidabutar et al. (2017) [79] | Indonesia | Cross-sectional/survey questionnaire | 80 | Unspecified | VIA | Unspecified | 2 |
| Wakhidah et al. (2017) [83] | Indonesia | Case-control/survey questionnaire | 150 | Unspecified | VIA | NA | 4 |
| Anwar et al. (2018) [73] | Indonesia | Cross-sectional/interview with structured questionnaire | 5397 |
Mean: 52.9 |
Pap smear | 5.5% | 5 |
| Winarti et al. (2018) [85] | Indonesia | Case-control/survey questionnaire | 410 | Unspecified | VIA | NA | 3 |
| Sidabutar et al. (2018) [80] | Indonesia | Cross-sectional/interview with structured questionnaire | 245 | Unspecified | VIA | 15.5% | 4 |
| Aprina et al. (2018) [71] | Indonesia | Cross-sectional/survey questionnaire | 361 | Unspecified | VIA | 26.9% | 3 |
| Rahmawati et al. (2018) [77] | Indonesia | Cross-sectional/survey questionnaire | 188 |
Range: 20–55 |
VIA | Desire to screen: 57.4% | 4 |
| Saptowati et al. (2018) [78] | Indonesia | Cross-sectional/survey questionnaire | 200 | Unspecified | VIA | Unspecified | 3 |
| Sutarti et al. (2018) [82] | Indonesia | Cross-sectional/survey questionnaire | 369 | Unspecified | Pap smear, VIA | Unspecified | 3 |
| Spagnoletti et al. (2019) [81] | Indonesia | Qualitative/focus group discussion and interview | Focus group: 17 Interview: 22 |
Range: Focus group female: 28–40 Focus group male: 35–45 Interview female: 22–57 |
Pap smear, VIA | 31.8% | 4 |
| Widayanti et al. (2020) [84] | Indonesia | Cross-sectional/interview | 126 |
Distribution: <20: 9 (7.1%) 20-30: 72 (57.1%) 30-40: 45 (35.7%) |
VIA | Willingness to screen: 45.2% | 2 |
| Muhith et al. (2020) [75] | Indonesia | Cross-sectional/survey questionnaire | 393 |
Range: 20–50 |
VIA | Unspecified | 2 |
| Phongsavan et al. (2010) [102] | Laos | Cross-sectional/interview with structured questionnaire | 800 |
Mean (SD): 34.0 (9.4) |
Pap smear | 4.5% | 5 |
| Sichanh et al. (2014) [103] | Laos | Case-control/interview with structured questionnaire | 640 |
Mean (SD): 36.2 (8.0) |
Pap smear | 3.9% | 5 |
| Hando et al. (2018) [104] | Laos | Cross-sectional/interview with structured questionnaire | 356 |
Mean (SD): 38.2 (9.8) |
Pap smear | 46.3% | 3 |
| Chee et al. (2003) [42] | Malaysia | Cross-sectional/survey questionnaire | 486 |
Mean (SD): 26.7 (6.2) |
Pap smear | 6.4% Within past 3 years: 4.3% |
2 |
| Chee et al. (2003) [24] | Malaysia | Cross-sectional/survey questionnaire | 1720 |
Mean (SD): 30.1 (7.9) |
Pap smear | 25.3% Within past 3 years: 18.4% |
4 |
| Asmani et al. (2007) [39] | Malaysia | Cross-sectional/survey questionnaire | 280 |
Distribution: <30: 49 (17.5%) 30–39: 79 (28.2%) 40–49:78 (27.9%) >50: 74 (26.4%) |
Pap smear | 51.4% | 4 |
| Moy et al. (2007) [40] | Malaysia | Cross-sectional/survey questionnaire | 112 |
Mean (SD): 35.8 (9.1) |
Pap smear | 61.6% | 4 |
| Wong et al. (2008) [30] | Malaysia | Qualitative/interview | 20 |
Mean (range): 32.2 (21–56) |
Pap smear | 0% | 4 |
| Othman et al. (2009) | Malaysia | Cross-sectional/survey questionnaire | 221 |
Mean (range): 51 (41–61) |
Pap smear | 51.8% | 2 |
| Wong et al. (2009) [45] | Malaysia | Qualitative/semi-structured interview | 20 |
Mean (range): 32.2 (21–56) |
Pap smear | 0% | 5 |
| Abdullah et al. (2010) [16] | Malaysia | Qualitative/semi-structured interview | 11 (providers) |
Range: 37–57 |
Pap smear | Unspecified | 5 |
| Al-Naggar et al. (2010) [18] | Malaysia | Cross-sectional/survey questionnaire | 285 |
Mean (SD): 20.9 (1.9) |
Pap smear | 6.0% | 3 |
| Al-Naggar et al. (2010) [17] | Malaysia | Qualitative/focus group discussion | 23 (17 females) |
Range: 22–26 |
Pap smear | Unspecified | 5 |
| Dunn et al. (2010) [46] | Malaysia | Cross-sectional/survey questionnaire | 1013 |
Mean (SD): 42.9 (10.1) |
Pap smear | 63.0% | 4 |
| Oon et al. (2010) [47] | Malaysia | Qualitative/interview with structured questionnaire | 52 (44 females) |
Range: 23–70 |
Pap smear | 79.5% | 5 |
| Abdullah et al. (2011) [15] | Malaysia | Cross-sectional/survey questionnaire | 403 |
Distribution: <35: 203 >35: 200 |
Pap smear | 38.0% | 5 |
| Al-Naggar et al. (2012) [33] | Malaysia | Cross-sectional/survey questionnaire | 142 |
Mean (SD): 31.6 (8.2) |
Pap smear | 46.5% | 3 |
| Aziz et al. (2013) [32] | Malaysia | Cross-sectional/interview with structured questionnaire | 3693 | Mean (SD): 36.7 years (7.7) |
Pap smear | Within past 3 years: 52.2% | 4 |
| Baskaran et al. (2013) [20] | Malaysia | Cross-sectional/interview with structured questionnaire | 369 |
Mean (SD): 37.5 years (10.0) |
Pap smear | 75.6% | 3 |
| Gan et al. (2013) [44] | Malaysia | Cross-sectional/interview with structured questionnaire | 959 |
Mean (SD): 45.2 (12.2) |
Pap smear | 48.9% Within past 3 years: 18.4% |
5 |
| Wong et al. (2013) [43] | Malaysia | Cross-sectional/survey questionnaire | 231 |
Median (IQR): Tested: 46 (37–53) Not tested: 30.5 (25–43) |
Pap smear | 55.8% | 4 |
| Azrai et al. (2015) [29] | Malaysia | Cross-sectional/interview with structured questionnaire | 98 |
Mean (SD): 42.9 (12.9) |
Self-HPV test | 78.6% (Pap smear) | 3 |
| Abdullah et al. (2016) [27] | Malaysia | Cross-sectional/interview with structured questionnaire | 515 |
Mean (SD): 58.8 (7.1) |
Pap smear | 39.2% | 5 |
| Danial et al. (2016) [21] | Malaysia | Cross-sectional/survey questionnaire | 337 |
Distribution: 18-30: 148 (43.9%) 31-40: 118 (35.0%) ≥41: 71 (21.1%) |
Pap smear | 32.9% | 4 |
| Ma’som et al. (2016) [25] | Malaysia | Cross-sectional/survey questionnaire | 839 |
Median (IQR): 38 (30–48) |
Pap smear | 63.1% | 3 |
| Indra et al. (2017) [37] | Malaysia | Cross-sectional/interview with structured questionnaire | 147 |
Range: 18–63 |
Pap smear | 77.6% | 4 |
| Razi et al. (2017) [38] | Malaysia | Cross-sectional/survey questionnaire | 187 |
Distribution: 20–29: 18 (9.6%) 30–39: 106 (56.7%) 40–49: 57 (30.5%) 50: 6 (3.2%) |
Pap smear | 65.2% Within past 3 years: 42.8% |
4 |
| Abdullah et al. (2018) [34] | Malaysia | Cross-sectional/survey questionnaire | 164 |
Mean (SD): 40.6 (8.4) |
Self-HPV test | 73.2% | 4 |
| Nwabichie et al. (2018) [22] | Malaysia | Cross-sectional/survey questionnaire | 320 |
Distribution: 18–30: 100 (31.3%) 31–50: 218 (68.1%) 51–69: 2 (0.6%) |
Pap smear | 27.5% Within past 3 years: 3.8% |
5 |
| Rubini et al. (2018) [31] | Malaysia | Cross-sectional/interview with structured questionnaire | 305 (males and females) |
Range: >18 |
Pap smear | Unspecified | 4 |
| Sundraraj et al. (2018) [26] | Malaysia | Cross-sectional/survey questionnaire | 246 | Unspecified | Pap smear | 28.5% | 2 |
| Yunus et al. (2018) [36] | Malaysia | Cross-sectional/survey questionnaire | 316 |
Mean (SD): 41.2 (9.2) |
Pap smear | Every 3 years: 9.5% Within past 3 years: 41.8% |
4 |
| Romli et al. (2019) [41] | Malaysia | Cross-sectional/survey questionnaire | 210 |
Mean (SD): 43.0 (10.3) |
Pap smear | 55.2% Within past 5 years: 38.6% |
5 |
| Siraj et al. (2019) [28] | Malaysia | Cross-sectional/survey questionnaire | 300 |
Distribution 17–40: 71 (23.7%) 41–50: 64 (21.3%) 51–60: 80 (26.7%) >60: 85 (28.3%) |
Pap smear | 57.0% | 4 |
| Baharum et al. (2020) [19] | Malaysia | Cross-sectional/survey questionnaire | 417 |
Mean (SD): 24.9 (3.6) |
Pap smear | Unspecified | 5 |
| Ting et al. (2020) [35] | Malaysia | Cross-sectional/self-administered online questionnaire | 246 |
Distribution: 20–30: 141 (57.3%) 31–40: 65 (26.4%) 41–50: 18 (7.3%) 51–60: 16 (6.5%) 61–70: 6 (2.4%) |
Pap smear | 48.0% | 4 |
| Nandar et al. (2015) [105] | Myanmar | Cross-sectional/interview with structured questionnaire | 666 |
Distribution: 30–39: 421 (64.1%) 40–49: 236 (35.9%) |
Unspecified | Within past 3 years: 19.1% | 5 |
| Seow et al. (1994) [89] | Singapore | Cross-sectional/survey questionnaire | 568 |
Distribution: 21–29: 65 (11.7%) 30–39: 189 (33.4%) 40–49: 152 (26.9%) 50–59: 126 (22.1%) 60–65: 34 (6.0%) |
Pap smear | 54.4% | 5 |
| Seow et al. (1995) [90] | Singapore | Cross-sectional/interview with structured questionnaire | 568 |
Distribution: 21- 29: 65 (11.7%) 30–39: 189 (33.4%) 40–49: 152 (26.9%) 50–59: 126 (22.1%) 60–65: 34 (6.0%) |
Pap smear | Unspecified | 5 |
| Seow et al. (2000) [88] | Singapore | Cross-sectional/interview with structured questionnaire | 447 |
Range: 45–69 |
Pap smear | 52.5% Within past 3 years: 34.9% |
5 |
| Lee et al. (2002) [87] | Singapore | Cross-sectional/interview with structured questionnaire | 726 |
Range: 30–59 |
Pap smear | 62.1% Every 3 years: 41.6% |
5 |
| Wee et al. (2010) [94] | Singapore | Cross-sectional/survey questionnaire | 213 (125 females) |
Median (IQR): 63.0 (49–76) |
Pap smear | Eligible for screening every 3 years and went: 2.9% | 4 |
| Wee et al. (2012) [95] | Singapore | Cross-sectional/survey questionnaire | 1081 (623 females) |
Distribution: 40–50: 257 (23.8%) 50–60: 301 (27.8%) 60–70: 192 (17.8%) ≥70: 331 (30.6%) |
Pap smear | Eligible for screening every 3 years and went: 31.3% | 4 |
| Shea et al. (2013) [91] | Singapore | Cross-sectional/survey questionnaire | 393 |
Mean (SD): 21.1 (1.4) |
Pap smear | 2.8% | 3 |
| Chirayil et al. (2014) [86] | Singapore | Cross-sectional/survey questionnaire | 206 |
Range: 18–26 |
Pap smear | 5.3% Within past 3 years: 3.9% |
3 |
| Wong et al. (2015) [98] | Singapore | Cross-sectional/survey questionnaire | 4337 (1993 eligible for cervical cancer screening) |
Range: 18–79 |
Pap smear | 69.2% Every 3 years: 43.8% |
5 |
| Tay et al. (2015) [92] | Singapore | Cross-sectional/survey questionnaire | 1622 |
Distribution: Not stated: 22 (1.4%) <25: 445 (27.4%) 25–29: 456 (28.1%) 30–34: 220 (13.6%) 35–39: 121 (7.5%) 40–44: 112 (6.9%) 45–49: 86 (5.3%) 50–54: 86 (5.3%) >54: 74 (4.6%) |
Unspecified | 50.2% Within past 3 years: 21.2% |
3 |
| Wee et al. (2016) [93] | Singapore | Mixed method/survey questionnaire and interview | 1996 (1154 females) /20 interviewed |
Distribution: <60 years: 964 (48.3%) ≥60 years: 1032 (51.7%) |
Pap smear | Every 3 years (rental flats): 18.0% | 4 |
| Wee et al. (2016) [96] | Singapore | Qualitative/interview | 29 (20 patients, 9 provider) |
Range of patient group: 40–59: 11 (55.0%) ≥60: 9 (45.0%) |
Pap smear | Unspecified | 5 |
| Wee et al. (2017) [97] | Singapore | Mixed method/survey questionnaire and interview | 2037 (855 females)/12 (6 females) |
Distribution: 40–50: 412 (20.2%) 51–60: 1625 (79.8%) |
Pap smear | Every 3 years: 24.9% | 5 |
| Yeo et al. (2018) [99] | Singapore | Cross-sectional/survey questionnaire | 268 |
Distribution: 21–34: 208 (77.9%) 35–50: 59 (22.1%) |
Pap smear | 38.7% | 4 |
| Boonmongkon et al. (2002) [68] | Thailand | Cross-sectional/survey questionnaire | 1028 | Unspecified | Pap smear | Within past 2 years: 34.6% | 2 |
| Kritpetcharat et al. (2003) [51] | Thailand | Cross-sectional/interview with structured questionnaire | 1199 |
Distribution: 20–29: 185 (15.4%) 30–39: 345 (28.8%) 40–49: 315 (26.3%) 50–59: 207 (17.3%) ≥60: 147 (12.3%) |
Pap smear | 66.9% | 3 |
| Boonpongmanee et al. (2007) [64] | Thailand | Cross-sectional/survey questionnaire | 189 |
Mean (SD): 36.8 (7.69) |
Pap smear | 51.9% | 3 |
| Chalapati et al. (2007) [49] | Thailand | Prospective quasi-experimental/interview | 200 |
Mean Intervention: 47.0 Control: 47.4 |
Pap smear | 72.5% | 5 |
| Kietpeerakool et al. (2009) [61] | Thailand | Cross-sectional/interview with structured questionnaire | 402 |
Mean (SD): 27.1 (6.6) |
Pap smear | 85.8% | 3 |
| Oranratanaphan et al. (2010) [59] | Thailand | Cross-sectional/survey questionnaire | 78 |
Mean: 32.5 |
Pap smear | 79.5% | 2 |
| Srisakul et al. (2011) [55] | Thailand | Cross-sectional/interview with structured questionnaire | 450 |
Mean (SD): 45.3 (4.2) |
Unspecified | Unspecified | 3 |
| Chesun et al. (2012) [56] | Thailand | Case-control/interview with structured questionnaire | 400 |
Mean (SD): Case: 42.1 (5.3) Control: 42.5 (5.0) |
Pap smear | Unspecified | 4 |
| Thanapprapasr et al. (2012) [50] | Thailand | Cross-sectional/survey questionnaire | 1365 |
Distribution: <30: 713 (53.6%) 31–40: 384 (28.9%) 41–50: 159 (12.0%) ≥50: 73 (5.5%) |
Pap smear | 36.6% | 4 |
| Budkaew et al. (2014) [54] | Thailand | Case-control/survey questionnaire and interview | 195 |
Mean (range): 46.0 (30–60) |
Pap smear | NA | 3 |
| Oranratanaphan et al. (2014) [66] | Thailand | Cross-sectional/survey questionnaire | 100 |
Mean (SD): 40.6 (9.3) |
Self-HPV test, pap smear | 81.0% | 2 |
| Wongwatcharanukul et al. (2014) [53] | Thailand | Cross-sectional/interview with structured questionnaire | 547 |
Mean (SD): 43.0 (8.6) |
Pap smear | 64.9% | 4 |
| Mukem et al. (2015) [62] | Thailand | Cross-sectional/survey questionnaire | Health and Welfare Survey: 11,046,520 |
Mean: Health and Welfare Survey: 51.3 |
Pap smear, VIA | Health and Welfare Survey: 46.3% | 5 |
| Polrit et al. (2015) [65] | Thailand | Case-control/interview with structured questionnaire | 452 |
Mean (SD) Case: 45.8 (7.8) Controls: 44.8 (9.8) |
Pap smear, VIA | NA | 5 |
| Srisuwan et al. (2015) [60] | Thailand | Cross-sectional/survey questionnaire and interview | 128 village health volunteers/ 10 patients |
Mean: Village health volunteer: 46.8 |
Pap smear | Unspecified | 3 |
| Visanuyothin et al. (2015) [52] | Thailand | Cross-sectional/survey questionnaire | 595 |
Distribution: 30–39: 154 (25.9%) 40–49: 219 (36.8%) 50–60: 222 (37.3%) |
Pap smear | Within 5-year interval: 65.4% | 5 |
| Chaowawanit et al. (2016) [58] | Thailand | Cross-sectional/survey questionnaire | 4339 |
Mean (SD): 46.6 (9.9) |
Unspecified | 65.3% Within 5-year interval: 42.8% |
5 |
| Kittisiam et al. (2016) [67] | Thailand | Cross-sectional/survey questionnaire | 2810 |
Mean (SD): 46.9 (9.9) |
Self-HPV test | Unspecified | 5 |
| Mongsawaeng et al. (2016) [57] | Thailand | Cross-sectional/survey questionnaire | 265 |
Distribution: 30–40: 63 (23.8%) 41–50: 113 (42.6%) 51–60: 89 (33.6%) |
Pap smear | 89.8% | 5 |
| Chongthawonsatid et al. (2017) [70] | Thailand | Cross-sectional/interview with structured questionnaire | 15,074,126 |
Distribution: 30–39: 5,561,306 (36.9%) 40–49: 5,487,316 (36.4%) 50–59: 4,025,504 (26.7%) |
Pap smear | 68.4% | 5 |
| Gottschlich et al. (2019) [48] | Thailand | Cross-sectional/survey questionnaire | 267 |
Mean (SD): 50.4 (5.8) |
Pap smear | 82.0% | 5 |
| Bunkarn et al. (2020) [63] | Thailand | Prospective quasi-experimental/survey questionnaire | 130 |
Mean (SD): 44.5 (8.3) |
Unspecified | Unspecified | 4 |
| Songsiriphan et al. (2020) [69] | Thailand | Cross-sectional/survey questionnaire | 300 |
Mean (SD): 45.0 (9.5) |
Pap smear | 89.3% | 4 |
| Vo et al. (2018) [106] | Vietnam | Qualitative/interview | 86 |
Distribution: 20–24: 15 (17.4%) 25–29: 12 (14.0%) 30–34: 32 (37.2%) 35–39: 27 (31.4%) |
Pap smear, VIA | 3.1% | 4 |
| Hoang et al. (2018) [107] | Vietnam | Mixed method/survey questionnaire and interview | 130 (113 females) |
Mean (SD): Residents: 21 (2.0) Migrants: 22 (1.7) |
Pap smear | 7.1% | 4 |
HPV: Human papilloma virus; MMAT: Mixed Methods Appraisal Tool; VIA: Visual inspection with acetic acid.