Barriers to Accessing Cervical Cancer Screening and Treatment in the Amazon Region-A Systematic Review.

Background/Objectives: Unequal access to cervical cancer screening and treatment remains a significant contributor to preventable morbidity and mortality for women in the Amazon Basin, compounded by geographic, social and infrastructural barriers. Given the fragmented nature of the existing evidence, this systematic review aims to synthesize available findings on barriers to cervical cancer screening and treatment for this region. The implications of these findings are examined to inform the development of actionable strategies to improve equity in prevention and care. Methods: This systematic review was conducted in accordance with PRISMA 2020. Searches were conducted on 7 November 2025, in PubMed/MEDLINE, Web of Science, and SciELO, utilizing combinations of MeSH terms, keywords, and free-text expressions. Studies were considered eligible if they addressed barriers to cervical cancer screening or treatment among women living in the Amazon Region. Two reviewers independently screened the studies and extracted the relevant data. The risk of bias was assessed using the JBI checklists, the Newcastle-Ottawa Scale, and the MMAT. A narrative synthesis summarized the results. Results: Of 57 studies identified, 11 were included. Organizational and health-system barriers were reported most frequently, including scheduling difficulties, long wait times, a shortage of professionals, and equipment unavailability. Socioeconomic barriers were most often related to younger age, low income, limited schooling, and care related expenses. Cultural factors were frequently linked to fear of the procedure and insufficient knowledge about cervical cancer. Geographic barriers included rural residence and travel difficulties. Conclusions: This systematic review indicates that disparities in cervical cancer screening in the Amazon region are primarily associated with organizational and health-system-related barriers, together with socioeconomic, cultural, and geographic factors. These findings highlight the need for equitable, multisectoral interventions to strengthen service organization, improve health literacy, and expand timely access to screening and treatment for underserved women.