Interventions to Eliminate Cervical Cancer in Nicaragua: An Integrative Review of the Literature.

Abstract

Introduction: Nicaragua has one of the highest cervical cancer death rates (19.4 per 100,000) compared to other Central American countries. This integrative review of the literature synthesizes cervical cancer prevention interventions in Nicaragua. Methods: The literature search was performed through Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embase, PubMed, and Scopus. The six articles included in this integrative review were appraised using the Quality Assessment Tool for Quantitative Studies (QAQTS). Results: Greater knowledge of Pap smears, the human papillomavirus (HPV), and cervical cancer was significantly associated with positive screening beliefs. Barriers to cervical cancer screening included access to Pap smears, preference for female providers, and the length of time to receive screening results and treatment. The probability of having a Pap smear was 94% higher among those who had a recent doctor's visit compared to those who had not. While clinician samples are more accurate in detecting HPV or cervical cancer, self-sampling was stated by the participants to be preferred. Conclusion: A focus on the higher efficacy of clinician sampling and providing more factual information about cervical cancer and its screening through trusted community-based efforts, such as charlas, would be more likely to encourage testing and thereby reduce the rate of cervical cancer in Nicaragua.