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Factors associated with attendance at screening for breast cancer : a systematic review and meta-analysis
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Mottram, Rebecca, Knerr, Wendy Lynn, Gallacher, Daniel C., Fraser, Hannah, Al-Khudairy, Lena, Ayorinde, Abimbola, Williamson, Sian, Nduka, Chidozie U., Uthman, Olalekan A., Johnson, Samantha Ann, Tsertsvadze, Alexander, Stinton, Christopher, Taylor-Phillips, Sian and Clarke, Aileen (2021) Factors associated with attendance at screening for breast cancer : a systematic review and meta-analysis. BMJ Open, 11 (11). e046660. doi:10.1136/bmjopen-2020-046660
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WRAP-Factors-associated-attendance-screening-breast-cancer-meta-analysis-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (2513Kb) | Preview |
Official URL: https://doi.org/10.1136/bmjopen-2020-046660
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.
| Item Type: | Journal Article | |||||||||||||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine R Medicine > RG Gynecology and obstetrics |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | |||||||||||||||
| Library of Congress Subject Headings (LCSH): | Breast -- Cancer -- Diagnosis, Breast -- Radiography, Medical screening, Meta-analysis | |||||||||||||||
| Journal or Publication Title: | BMJ Open | |||||||||||||||
| Publisher: | BMJ Publishing Group | |||||||||||||||
| ISSN: | 2044-6055 | |||||||||||||||
| Official Date: | 30 November 2021 | |||||||||||||||
| Dates: |
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| Volume: | 11 | |||||||||||||||
| Number: | 11 | |||||||||||||||
| Article Number: | e046660 | |||||||||||||||
| DOI: | 10.1136/bmjopen-2020-046660 | |||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||
| Publication Status: | Published | |||||||||||||||
| Publisher Statement: | ** Embargo end date: 30-11-2021 ** From BMJ via Jisc Publications Router ** History: received 05-11-2020; accepted 17-09-2021; ppub 11-2021; epub 30-11-2021. ** Licence for this article starting on 30-11-2021: https://creativecommons.org/licenses/by/4.0/ | |||||||||||||||
| Access rights to Published version: | Open Access | |||||||||||||||
| RIOXX Funder/Project Grant: |
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