Association between comorbidity and participation in breast and cervical cancer screening: a systematic review and meta-analysis

Diaz, Abbey, Kang, Jimin, Moore, Suzanne P., Baade, Peter, Langbecker, Danette, Condon, John R. and Valery, Patricia C. (2017) Association between comorbidity and participation in breast and cervical cancer screening: a systematic review and meta-analysis. Cancer Epidemiology, 47 7-19. doi:10.1016/j.canep.2016.12.010


Author Diaz, Abbey
Kang, Jimin
Moore, Suzanne P.
Baade, Peter
Langbecker, Danette
Condon, John R.
Valery, Patricia C.
Title Association between comorbidity and participation in breast and cervical cancer screening: a systematic review and meta-analysis
Journal name Cancer Epidemiology   Check publisher's open access policy
ISSN 1877-783X
1877-7821
Publication date 2017-04-01
Year available 2017
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.canep.2016.12.010
Open Access Status Not yet assessed
Volume 47
Start page 7
End page 19
Total pages 13
Place of publication New York, NY, United States
Publisher Elsevier
Language eng
Abstract Background: Comorbidity is associated with poor outcomes for cancer patients but it is less clear how it influences cancer prevention and early detection. This review synthesizes evidence from studies that have quantified the association between comorbidity and participation in breast and cervical screening.
Formatted abstract
Background: Comorbidity is associated with poor outcomes for cancer patients but it is less clear how it influences cancer prevention and early detection. This review synthesizes evidence from studies that have quantified the association between comorbidity and participation in breast and cervical screening.

Methods: PubMed, CINAHL and EMBASE databases were systematically searched using key terms related to cancer screening and comorbidity for original research articles published between 1 January 1991 and 21 March 2016. Two reviewers independently screened 1283 studies that met eligibility criteria related to Population (adult, non-cancer populations), Exposure (comorbidity), Comparison (a ‘no comorbidity’ group), and Outcome (participation in breast cancer or cervical screening). Data was extracted and risk of bias assessed using a standardised tool from the 22 studies identified for inclusion (17 breast; 13 cervical). Meta-analyses were performed for participation in breast and cervical screening, stratified by important study characteristics.

Results: The majority of studies were conducted in the United States. Results of individual studies were variable. Most had medium to high risk of bias. Based on the three “low risk of bias” studies, mammography screening was less common among those with comorbidity (pooled Odds Ratio 0.66, 95%CI 0.44–0.88). The one “low risk of bias” study of cervical screening reported a negative association between comorbidity and participation.

Conclusion: While a definitive conclusion could not be drawn, the results from high quality studies suggest that women with comorbidity are less likely to participate in breast, and possibly cervical, cancer screening.
Keyword Breast neoplasms
Cancer screening
Cervical neoplasms
Chronic disease
Comorbidity
Early detection of cancer
Mammography
Meta-analysis
Multimorbidity
Papanicolaou test
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 1041111
SRP 13-01
1055587
1072061
1083090
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: HERDC Pre-Audit
Faculty of Medicine
Centre for Health Services Research Publications
Admin Only - Centre for Health Services Research
 
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