Strong association between cervical and breast cancer screening behaviour among Danish women; A register-based cohort study

Larsen, Steffen Falgreen; Virgilsen, Line Flytkjær; Kristiansen, Bettina Kjær; Andersen, Berit; Vedsted, Peter

doi:10.1016/j.pmedr.2018.10.017

Cited by 11 publications

(9 citation statements)

References 35 publications

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“…In brief, the searches of electronic databases identified 11 953 unique publications (after deduplication), published between January 1987 and June 2019, of which 11 618 were excluded at the level of abstract/title screening, leaving 335 records for full-text review. Of the 335 full texts, 66 unique studies reported in 67 publications were included 18 20–87…”

Section: Resultsmentioning

confidence: 99%

Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis

et al. 2021

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ObjectiveAttendance 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.DesignCINAHL, 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 synthesisIndependent 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.ResultsOf 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.ConclusionsAttendance 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 numberCRD42016051597.

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Section: Resultsmentioning

confidence: 99%

Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis

et al. 2021

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“…All studies reported that with increasing morbidity score, the odds of screening attendance decreased. Three studies reported that any Charlson score resulted in reduced attendance compared with those without (29)(30)(31), whereas one reported that individuals with a score of 1-2 were more likely to attend than those with either a score of 0 or 3 or more (32).…”

Section: Resultsmentioning

confidence: 99%

“…Of four studies reporting the impact of CCI scores (characteristics and results summarized in Table 2 ), three were conducted in Denmark ( 29–31 ), and one in the UK ( 32 ). Two studies reported results as CCI 1 versus ≥2 ( 29, 30 ), and the remaining used 1–2 versus ≥3 ( 31, 32 ) compared with no morbidity as comparison. Thus, meta-analyses were not appropriate for this outcome.…”

Section: Resultsmentioning

confidence: 99%

The Impact of Morbidity and Disability on Attendance at Organized Breast Cancer–Screening Programs: A Systematic Review and Meta-Analysis

McWilliams

Groves

Howell

et al. 2022

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Individuals with morbidity, experience worse breast cancer outcomes compared to those without. This meta-analysis assessed the impact of morbidity on breast cancer screening attendance and subsequent early detection (PROSPERO pre-registration CRD42020204918). MEDLINE, PsychInfo and CINAHL were searched. Included articles published from 1988 measured organised breast screening mammography attendance using medical records by women with morbidity compared to those without.. Morbidities were assigned to nine diagnostic clusters. Data were pooled using random-effects inverse meta-analyses to produce odds ratios (OR) for attendance.. 25 study samples (28 articles) were included. Data were available from 17,755,075 individuals including at least 1,408,246 participants with one or more conditions;16,250,556 had none. Individuals with any morbidity had lower odds of attending breast screening compared to controls (k=25,OR=0.76[95% CI 0.70-0.81],p=<0.001,I2=99%). Six morbidity clusters had lower odds of attendance. The lowest were for neurological, psychiatric and disability conditions; odds ratios ranged from 0.45-0.59 compared to those without. Morbidity presents a clear barrier for breast screening attendance, exacerbating health inequalities and, includes a larger number of conditions than previously identified. Consensus is required to determine a standardised approach on how best to identify those with morbidity and determine solutions for overcoming barriers to screening participation based on specific morbidity profiles.

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“…Visiting a gynaecologist is highly correlated with uptake of BCS and CCS, while a strong association between BCS and CCS participation also exists [11][12][13][14][15] . To overcome the methodological limits induced by these correlations, it is thus necessary to simultaneously account for these three dimensions.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10] Visiting a gynaecologist is highly correlated with uptake of BCS and CCS, while a strong association between BCS and CCS participation also exists. [11][12][13][14][15] To overcome the methodological limits induced by these correlations, it is thus necessary to simultaneously account for these three dimensions. In addition, while studies usually investigate whether women are up-to-date for BCS or CCS, looking at the regularity of BCS and CCS in relation to that of visits to a gynaecologist may provide new insights into the relationship between BMI and cancer screening.…”

Section: Introductionmentioning

confidence: 99%

Patterns of gynaecological check-up and their association with body mass index within the CONSTANCES cohort

et al. 2020

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Objectives To investigate the relationship between patterns of gynaecological check-up and body mass index while accounting for various determinants of health care use. Methods Sequence analysis and clustering were used to highlight patterns of gynaecological check-up, which included the regularity of breast and cervical cancer screening and visits to the gynaecologist over four years, among 6182 women aged 54–65 included in the CONSTANCES cohort between 2013 and 2015 in France. Multinomial logistic regressions were used to study the association between these patterns and women’s body mass index. Results We identified four patterns of gynaecological check-up, from (A) no or inappropriate check-up (20%) to (D) almost one visit to the gynaecologist every year, overscreening for cervical cancer and frequent use of opportunistic breast cancer screening (12%). From patterns A to D, the proportion of obese women decreased and that of women with normal body mass index increased. Obese and overweight women underwent more breast than cervical cancer screening and were less often overscreened than normal weight women. These differences were only partly explained by the lower socioeconomic situation of overweight and obese women. Beyond the financial barrier, the screening modality and the type of exam may play a role. Among women who were screened for cervical cancer, obese and overweight women were less often screened by a gynaecologist. Conclusion Further efforts should be made to enhance the take-up of screening among obese women who are deterred by the healthcare system.

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Strong association between cervical and breast cancer screening behaviour among Danish women; A register-based cohort study

Cited by 11 publications

References 35 publications

Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis

Factors associated with attendance at screening for breast cancer: a systematic review and meta-analysis

The Impact of Morbidity and Disability on Attendance at Organized Breast Cancer–Screening Programs: A Systematic Review and Meta-Analysis

Patterns of gynaecological check-up and their association with body mass index within the CONSTANCES cohort

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