A systematic literature review on implementation of cervical cancer screening and associated factors in Nepal: study protocol

Article type
Authors
Shrestha A1, Greibe Andersen J1, Neupane D2, Ghimire S3, Campbell C4, Kallestrup P1
1Center for Global Health, Department of Public Health, Aarhus University
2Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
3Nepal Cancer Care Foundation
4Usher Institute, University of Edinburgh
Abstract
Background:
Cervical cancer is a major cause of cancer death among women in Nepal. The high burden of this disease necessitates identifying relevant evidence to inform policy development and guidelines. This protocol describes a planned systematic review that will collate and report the experiences of implementation of cervical cancer screening and associated factors in Nepal over the last two decades to identify knowledge gaps to inform future implementation strategies.

Objectives:
• Identify relevant peer-reviewed and grey literature describing cervical cancer screening delivery and coverage among women in Nepal
• Describe and synthesize the experiences of implementing cervical cancer screening in Nepal
• Identify any barriers to and facilitators of cervical cancer screening coverage in Nepal described in the literature
• Collate major findings and recommendations on cervical cancer screening from studies conducted in Nepal from 1 January 2000 to 31 December 2018.

Methods:
This protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA_P) statement and will apply eligibility criteria to screening and select peer-reviewed research articles and grey literature. The systematic review has been registered with PROSPERO (CRD42019144645). The study protocol has been published in the Journal of Global Health reports and cited as, ''Shrestha AD, Andersen JG, Neupane D, Ghimire S, Campbell C, Kallestrup P. Protocol for systematic literature review on implementation of cervical cancer screening and associated factors in Nepal from 2000 to 2018. Journal of Global Health Reports. 2020;4:e2020023".

A computer-based search will be conducted for each type of publication in the PubMed/MEDLINE, CINAHL, Scopus and EMBASE databases using various search terms. Search terms will be modified according to each database and the reference lists of the included studies will be screened to identify additional relevant materials. Data synthesis will use narrative synthesis and meta-analysis where appropriate.

ETHICS AND DISSEMINATION:
This study does not require ethical approval as only secondary data from published and grey literature will be assessed. The review will be published in a peer-reviewed scientific journal.

Patient or healthcare consumer involvement:
Patients and the public are not involved in this study.