Cervical Cancer Knowledge and Facilitators and Barriers to Screening Among Women in Two Rural Communities in Guatemala: A Qualitative Study

Background: Approximately 80% of deaths due to cervical cancer occur in the developing world. In Guatemala, limited access to effective screening and treatment has resulted in an alarmingly high cervical cancer incidence and mortality rates. Despite access to free-of-cost screening women continue to face significant barriers in obtaining screening for cervical cancer. Methods: In-depth interviews (N=21) were conducted among women in two rural communities in Guatemala. Qualitative IDIs followed semi-structured guide to explore knowledge related to cervical cancer and barriers and facilitators to cervical cancer screening. Results: Cervical cancer knowledge was variable across sites and across women. Women reported barriers to screening including ancillary costs, control by male partners, poor provider communication and systems-level resource constraints. Facilitators to screening included a desire to know one’s own health status, conversations with other women including community health workers and extra-governmental health fairs. Conclusions: Findings speak to the many challenges women face in obtaining screening for cervical cancer in their communities as well as existing facilitators. Future interventions must focus on improving cervical cancer-related knowledge as well as mitigating barriers and leveraging facilitators to promote screening.