Disparities in Human Papillomavirus Vaccination and Cervical Cancer Prevention and Screening Strategies: A Meta-Analysis

Juntamongkol, Tunchanok; Siranart, Noppachai; Phutinart, Somkiat; Chitwarodom, Chanawee; Kassels, Tanattida; Tachapornsin, Panchaya; Leemingsawat, Pranyu; Pajareya, Patavee; Phoolcharoen, Natacha

doi:10.31557/APJCP.2025.26.11.3997

Disparities in Human Papillomavirus Vaccination and Cervical Cancer Prevention and Screening Strategies: A Meta-Analysis

Document Type : Systematic Review and Meta-analysis

Authors

¹ Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

² Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Boston, Massachusetts, USA.

³ Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

10.31557/APJCP.2025.26.11.3997

Abstract

Background: Sociodemographic disparities continue to impact access to cervical cancer screening and treatment outcomes. Although advancements in preventive and therapeutic strategies have contributed to reductions in cervical cancer incidence and mortality, inequities in healthcare access remain largely influenced by social gradients and limited health literacy. Method: This study aimed to investigate the influence of factors such as age, race, socioeconomic status, educational attainment, and insurance coverage on cervical cancer mortality and participation in preventive measures, including HPV vaccination and cervical cancer screening. A systematic search of the MEDLINE, EMBASE, and Cochrane databases was conducted through January 2024. Eligible studies examined associations between disparities, defined as differences in race, social determinants of health, treatment modalities, and cervical cancer prevention or mortality. Data were synthesized using a random-effects meta-analysis, supplemented by subgroup analyses and multiple meta-regression models. Results: A total of 69 studies met the inclusion criteria. Screening participation was higher among individuals who were non-Black, had attained higher education levels, were publicly insured, were married, and had a higher income. In contrast, higher cervical cancer mortality rates were observed among individuals who were Black, uninsured, less educated, unmarried, or those who either did not receive treatment or underwent surgery alone. Conclusion: Significant disparities persist in access to cervical cancer prevention services and in mortality outcomes. These findings highlight the urgent need for policy interventions aimed at addressing economic, social, and racial barriers to equitable healthcare access.

Keywords