Systematic review · 2026

Why do some people miss follow-up after a positive HPV test?

Short answer

A systematic review found that limited health-service capacity, unclear test results and practical barriers can make it difficult to complete necessary follow-up after a positive HPV screening test.

What did the researchers examine?

The researchers searched MEDLINE, Embase, Scopus and Web of Science for English-language studies published between 2015 and 2025. Two reviewers independently screened studies. Fifteen studies from twelve locations in Africa, Europe, North America and South America were included. Findings were synthesised thematically.

What did they find?

Health services: waiting times, limited capacity and lack of local treatment.
Knowledge and communication: uncertainty about HPV results and next steps.
Emotional factors: fear of treatment, stigma and distrust.
Social factors: partner influence, gender roles and lack of support.
Practical factors: transport, costs and work conflicts.

Across studies, missed follow-up appeared more strongly associated with health-system and practical barriers than with a lack of motivation.

How certain are we?

Studies came from different countries and health systems. The thematic synthesis provides no pooled effect size or reliable estimate for Norway. The review identifies barriers but does not establish the effectiveness of any single intervention.

Who do the findings apply to?

People with a positive HPV screening test who may need further examination or treatment. Applicability to Norwegian services requires separate assessment.

What could this mean in everyday life?

Clear information about test results and accessible follow-up examinations matter. In Norway, follow-up depends on HPV type, cell changes and previous test results. Follow your doctor's recommendation.

How does this fit with other research?

Earlier studies explored whether HPV self-sampling increases screening participation. This review examines barriers that may arise after a positive result.

What do we need to know more about?

Which interventions make follow-up easier in different health systems, and which groups face the greatest barriers.

Explore further

Sources

Beetch J, Bittencourt L, Gutierrez R, Canon Lovera D, Pratt RJ. Barriers limiting access to follow-up care after HPV screening for cervical cancer in global settings: A systematic review. Epidemiologic Reviews. 2026. DOI: 10.1093/epirev/mxag017. PMID: 42970951.

Source checked 9 November 2026 against the publisher's published abstract of the accepted manuscript. Full text has not been reviewed.