Objectives The aim of this review was to identify the cultural, social, structural and behavioural factors that influence asymptomatic breast and cervical cancer screening attendance in South Asian populations, in order to improve uptake and propose priorities for further research. Design A systematic review of the literature for inductive, comparative, prospective and intervention studies. We searched the following databases: MEDLINE/In-Process, Web of Science, EMBASE, SCOPUS, CENTRAL, CDSR, CINAHL, PsycINFO and PsycARTICLES from database inception to 23 January 2018. The review included studies on the cultural, social, structural and behavioural factors that influence asymptomatic breast and cervical cancer screening attendance and cervical smear testing (Papanicolaou test) in South Asian populations and those published in the English language. The framework analysis method was used and themes were drawn out following the thematic analysis method. Settings Asymptomatic breast or cervical screening. Participants South Asian women, including Bangladeshi, Indian, Pakistani, Sri Lankan, Bhutanese, Maldivian and Nepali populations. Results 51 included studies were published between 1991 and 2018. Sample sizes ranged from 25 to 38 733 and participants had a mean age of 18 to 83 years. Our review showed that South Asian women generally had lower screening rates than host country women. South Asian women had poorer knowledge of cancer and cancer prevention and experienced more barriers to screening. Cultural practices and assumptions influenced understandings of cancer and prevention, emphasising the importance of host country cultures and healthcare systems. Conclusions High-quality research on screening attendance is required using prospective designs, where objectively validated attendance is predicted from cultural understandings, beliefs, norms and practices, thus informing policy on targeting relevant public health messages to the South Asian communities about screening for cancer. PROSPERO registration number CSD 42015025284. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018.

Cervical cancer mammography Breast cancer asymptomatic screening smear South Asian Women

Pakistan cultural anthropology breast cancer India South Asian minority group health insurance human health belief Asian continental ancestry group early cancer diagnosis cancer prevention cancer screening Early Detection of Cancer ethnology Bhutan Sri Lanka social status Breast Neoplasms migrant Humans Emigrants and Immigrants breast tumor Acculturation female Review cultural factor Health Knowledge, Attitudes, Practice Health Belief Model thematic analysis health education uterine cervix cancer Uterine Cervical Neoplasms Papanicolaou Test uterine cervix tumor Culturally Competent Care Bangladesh Cultural Characteristics transcultural care health care system Nepal systematic review barrier contraception attitude to health