For our study the aim is to assess the determinants of non-participation in the population-based breast cancer screening programmes with a meta-analysis.
What were the inclusion/exclusion criteria and databases used in this systematic review?
We searched the main three databases, the PubMed, the Embase and also the Web of Science. So we included studies that reported data on the relationship between the determinants and the non-participation in breast cancer screening programmes with mammography which means the screening modality has to be mammography; also, the studies are published in English.
We excluded studies based on four criteria: first is if the studies were only reporting data on opportunistic breast cancer screening or if the studies only reported self-reporting screening compliance data. The third is if the studies focussed on the determinants of the re-attendance to the screening. Lastly is the non-original studies such as the case reports, letters, comments, editorials, reviews and conference abstracts were excluded.
What were the key outcomes observed in this review?
The main outcome of our study was that we included 33 studies in our systematic review and 24 studies were eligible for our meta-analysis. So in these studies we found nine determinants of screening non-participation. Amongst them, five determinants were significant. They included the income level of women, education level of women and the living distance to the screening unit, also, the marital status and the immigration status. So, for example for the income level, women with a low income level had higher non-participation compared to women with high income.
The effective size of these five determinants ranged between 1.10 and 1.44, that’s basically the main results.
How can the results from this study impact population-based breast cancer screening in the future?
The implications of our results are twofold. First we provided the quantitative evidence of the determinants of non-participation in the population-based breast cancer screening programmes in a wide range of countries. The women that are characterised by these significant determinants have less likelihood to attend the breast cancer screening programme which means that women that are characterised by these determinants can be identified in the larger population. So our results can inform the policymakers in the making of health policies to be more engaging for this group of women.
Secondly, our result is also an indication that the current criteria in a lot of countries that select women for invitation to the screening programme only based on their age might need some modification. For example, a more personalised invitation strategy maybe can help.
