Barriers and Enablers to Cervical Cancer Screening Among Culturally Diverse Women in Australia: A Mixed Methods Study

Background and Aims: Despite advances in cervical cancer prevention through HPV vaccination and self collection screening options, participation remains disproportionately low among culturally and linguistically diverse (CALD) women in Australia. Despite national policy efforts, uptake remains low. This study aims to bridge the gap between policy and lived experience by synthesising evidence and capturing perspectives to understand why screening remains inaccessible and how it can be transformed. Methods: A narrative review of peer reviewed and grey literature (2015 to 2024) was conducted to identify structural and cultural barriers affecting cervical screening participation in CALD populations. Key themes were mapped against the socioecological model. In parallel, semistructured interviews were conducted with eight multicultural health workers and cultural advisors across South Australia. Thematic analysis was used to identify recurring patterns, community insights, and practice level solutions. Ethics approval was granted by the University of South Australia Human Research Ethics Committee. Results: Literature consistently reported language barriers, lack of culturally safe information, and limited awareness of self collection options. Interviewees deepened this with lived insight, describing mistrust, stigma, and fear, especially among women from refugee and faith-based communities. They proposed actionable strategies: co-designed messaging, partnerships with cultural leaders, and embedding screening education into community spaces of women. Importantly, the disconnect between national messaging and local realities was seen as a critical barrier to meaningful engagement. Conclusions and Significance/Impact: This study reveals that closing the cervical screening gap for CALD women requires more than information. It demands cultural trust, community leadership, and policy grounded in real world experience. By combining evidence with voice, it offers a roadmap for developing inclusive, community led screening programs. The findings advance translational public health by demonstrating how innovation begins with listening and leads to systems that truly work for all.