Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 52 11 2023 10 29 2313 2324 Narges Pirani 1. Health Policy, Ministry of Health and Medical Education, Tehran, Iran 2. Health Promotion Research Center, Health School, Iran University of Medical Sciences, Tehran, Iran Mehdi Jafari Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Rafat Bagherzadeh English Department, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Marziyeh Keikhosravi Ganjavian Hospital, Khuzestan, Iran Hadis Pirani Public Administration, Payam Noor University, Khuzestan, Iran 2022 07 04 2023 03 29 Background: Widespread use of screening in high-income countries has led to significant reductions in mortality from cervical cancer. However, in Iran, the main reason for the late diagnosis of cervical cancer was the failure to perform a Pap smear (Papanicolaou).  We aimed to investigate the status of cervical cancer prevention and its challenges and solutions in Iran. Method: We conducted a systematic review of literature published from 1974 to 2021 in the electronic databases, including PubMed, Web of Science, Embase, Scopus, and Google Scholar, and retrieved all English-language articles. Following the application of the inclusion and exclusion criteria, full-text articles were identified and evaluated for eligibility. Finally, these publications were analyzed as part of the synthesis. Results: Lower social-economic level, inadequate knowledge of screening tests and health centers for Pap test performance leading to worse outcomes such as lower screening participation or coverage. Conclusion: By addressing these challenges through increasing education, increasing service accessibility, expanding screening programs, improving public awareness, improving insurance coverage, and establishing a control protocol for follow-up, it is possible to reduce cervical cancer incidence and mortality. https://ijph.tums.ac.ir/index.php/ijph/article/view/29202 https://ijph.tums.ac.ir/index.php/ijph/article/download/29202/8082