• Brody Olson, Beth Gribble, Jasmyni Dias, Cassie Curryer, Kha Vo, Paul Kowal, and Julie Byles.
• Research Centre for Generational Health and Ageing, School of Medicine and Public Health, HMRI Building, University of Newcastle, Callaghan, NSW, Australia 2308.
• Int J Gynaecol Obstet. 2016 Sep 1; 134 (3): 239-46.

BackgroundScreening reduces cervical cancer incidence and mortality.ObjectiveTo describe cervical cancer epidemiology and screening guidelines in six low- and middle-income countries (LMICs) participating in the Study on global AGEing and adult health (SAGE).Search StrategyIncidence, mortality, and screening-rate data were obtained for six LMICs and three higher-income comparator countries (Australia, USA, and UK). SCOPUS and PubMed were used to identify literature published after 2000 in English, using several screening-linked terms.Selection CriteriaLiterature describing the use of cervical cancer screening guidelines in China, Ghana, India, Mexico, Russia, and South Africa were included.Data Collection And AnalysisIncidence, mortality trends, and screening rates were graphed and screening recommendations were summarized.Main ResultsHigher rates of cervical cancer incidence, mortality, and 5-year prevalence were found in LMICs compared with the comparator countries. LMICs with absent or newly implemented screening guidelines had the lowest rates of crude and effective cervical cancer screening, with high cancer incidence and mortality. Countries with established guidelines had higher screening rates and lower disease burden. Cost, inadequate knowledge, geographical location, and cultural views were common barriers to effective screening coverage.ConclusionWork must continue to improve the implementation of affordable, relevant, and achievable methods to improve screening coverage in LMICs.Copyright © 2016. Published by Elsevier Ireland Ltd.

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