AI Article Synopsis
- This systematic review analyzed factors affecting attendance at breast cancer screening, focusing on patient-level characteristics across studies published between 1987 and 2019.
- Out of nearly 20,000 studies reviewed, 66 were included, highlighting that higher socioeconomic status, income, home ownership, being non-immigrant, being married, and having medium education levels were linked to increased screening attendance, while previous false-positive results decreased likelihood of reattending.
- The study concluded that women with lower socioeconomic status and immigrants showed lower attendance rates, suggesting that practical and psychological barriers may play a crucial role in screening uptake.
Article Abstract
Objective: Attendance at population-based breast cancer (mammographic) screening varies. This comprehensive systematic review and meta-analysis assesses all identified patient-level factors associated with routine population breast screening attendance.
Design: CINAHL, Cochrane Library, Embase, Medline, OVID, PsycINFO and Web of Science were searched for studies of any design, published January 1987-June 2019, and reporting attendance in relation to at least one patient-level factor.
Data Synthesis: Independent reviewers performed screening, data extraction and quality appraisal. OR and 95% CIs were calculated for attendance for each factor and random-effects meta-analysis was undertaken where possible.
Results: Of 19 776 studies, 335 were assessed at full text and 66 studies (n=22 150 922) were included. Risk of bias was generally low. In meta-analysis, increased attendance was associated with higher socioeconomic status (SES) (n=11 studies; OR 1.45, 95% CI: 1.20 to 1.75); higher income (n=5 studies; OR 1.96, 95% CI: 1.68 to 2.29); home ownership (n=3 studies; OR 2.16, 95% CI: 2.08 to 2.23); being non-immigrant (n=7 studies; OR 2.23, 95% CI: 2.00 to 2.48); being married/cohabiting (n=7 studies; OR 1.86, 95% CI: 1.58 to 2.19) and medium (vs low) level of education (n=6 studies; OR 1.24, 95% CI: 1.09 to 1.41). Women with previous false-positive results were less likely to reattend (n=6 studies; OR 0.77, 95% CI: 0.68 to 0.88). There were no differences by age group or by rural versus urban residence.
Conclusions: Attendance was lower in women with lower SES, those who were immigrants, non-homeowners and those with previous false-positive results. Variations in service delivery, screening programmes and study populations may influence findings. Our findings are of univariable associations. Underlying causes of lower uptake such as practical, physical, psychological or financial barriers should be investigated.
Trial Registration Number: CRD42016051597.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634222 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2020-046660 | DOI Listing |
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