1. Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis.
- Author
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Mottram R, Knerr WL, Gallacher D, Fraser H, Al-Khudairy L, Ayorinde A, Williamson S, Nduka C, Uthman OA, Johnson S, Tsertsvadze A, Stinton C, Taylor-Phillips S, and Clarke A
- Subjects
- Early Detection of Cancer, Female, Humans, Mammography, Mass Screening, Breast Neoplasms diagnosis, Breast Neoplasms epidemiology, Text Messaging
- 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., Competing Interests: Competing interests: RM reports personal fees from the National Institute for Health Research (NIHR) Centre for Leadership in Applied Research and Health Care (CLARHC) West Midlands during the conduct of the study. LA-K reports grants from the NIHR during the conduct of the study. ST-P reports grants from NIHR outside the submitted work. AC reports grants from the NIHR for the NIHR Applied Research Centre (ARC) West Midlands and previously from the NIHR CLARHC West Midlands, which supported her and researchers working on this project. AC also received grants from Public Health England (PHE) outside the submitted work., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
- Published
- 2021
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