What Hinders Participation in Oral Cancer Screening? A Scoping Review on Unveiling the Barriers

Background Oral cancer remains a significant global public health issue, with high incidence and mortality rates. Despite the availability of screening programs and advancements in diagnostic technologies, participation in oral cancer screening remains suboptimal, contributing to late-stage diagnoses and poor prognoses. Objectives This scoping review aims to systematically map the existing literature to identify and synthesize the barriers hindering oral cancer screening participation. The study explores individual, cultural, and systemic factors contributing to low screening uptake and highlights potential facilitators that could enhance participation rates. Methods Following the Arksey and O’Malley framework, as refined by Levac et al., a systematic literature search was conducted across PubMed, Web of Science, Scopus, and Google Scholar. Studies published between January 2000 and April 2024 in English were included. Thematic analysis was employed to categorize barriers and facilitators. Results The final analysis included a total of 55 studies, which identified barriers to oral cancer screening across four main themes. Micro (individual) barriers encompassed factors such as fear of diagnosis, lack of awareness, misconceptions, and a limited perceived need for screening. Macro (systemic) barriers included economic constraints, inadequate healthcare infrastructure, and a shortage of trained professionals, particularly in low-resource settings. Cultural and social barriers were characterized by stigma, gender disparities, and misinformation about oral cancer and screening procedures. Despite these challenges, facilitators and innovations such as AI-driven diagnostics, mobile health (mHealth) applications, and community-based interventions have shown effectiveness in enhancing screening participation. Conclusions Barriers to oral cancer screening are multi-dimensional, requiring region-specific, integrated strategies to improve screening uptake. Targeted interventions, including awareness campaigns, subsidized screening programs, and the integration of technology-driven solutions, are critical for overcoming individual and systemic challenges. Policymakers and healthcare providers must adopt a multidisciplinary approach to enhance accessibility, affordability, and acceptability of screening services, particularly in high-risk and underserved populations.