Understanding the Pap Testing Behaviors of African Immigrant Women in Developed Countries: A Systematic Review

Joycelyn Cudjoe, Manka Nkimbeng, Ruth Alma Turkson-Ocran, Yvonne Commodore-Mensah, Hae Ra Han

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Background: African immigrant (AI) women remain burdened by cervical cancer, but the prevalence and correlates of Pap testing remains unclear in this population. Objective: To review studies on the prevalence and determinants of Pap testing among AI women living in developed countries. Methods: PubMed, CINAHL, Embase, and Scopus were searched for relevant articles that included African-born immigrant participants; were published in English; addressed the prevalence of Pap testing; conducted in a developed country; and identified correlates of Pap testing behavior. The Andersen Behavioral Model guided synthesis of the key findings. Results: Sixteen studies met the inclusion criteria. The prevalence of Pap testing ranged from 4.6% to 73.0%. Having a female provider and access to primary care facilitated Pap testing. Barriers to Pap testing included low income, male healthcare providers, and no history of gynecological exam. Conclusions: Healthcare providers and social determinants-particularly income and healthcare access, play an important role in improving Pap testing among AI women. Larger qualitative and mixed methods studies are needed to explore other important determinants of Pap testing such as disease knowledge, self-efficacy, health literacy to reduce the burden of cervical cancer among AI women.

Original languageEnglish (US)
JournalJournal of Immigrant and Minority Health
StateAccepted/In press - 2020

Bibliographical note

Funding Information:
This research is supported by a predoctoral grant from the National Cancer Institute (F31CA221096), and a scholarship from Sigma Theta Tau International-Nu Beta Chapter. The content of this review is solely the responsibility of the authors and does not necessarily represent the official views of the afore-mentioned funding sources including the National Cancer Institute of the National Institutes of Health. Acknowledgements

Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.


  • African immigrants
  • Cervical cancer
  • Pap smear
  • Systematic review


Dive into the research topics of 'Understanding the Pap Testing Behaviors of African Immigrant Women in Developed Countries: A Systematic Review'. Together they form a unique fingerprint.

Cite this