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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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Official URL: https://doi.org/10.1136/bmjopen-2020-046660

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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
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
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:
DateEvent
30 November 2021Published
17 September 2021Accepted
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:
Project/Grant IDRIOXX Funder NameFunder ID
NIHR CLAHRC WM[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
NIHR ARC WM[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Official Development Assistance Funding[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
CDF-2016-09-018[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
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