Does Women's Screening History Have Any Impact on Mammography Screening Attendance After Tailored Education?: A Systematic Review and Meta-analysis

Med Care. 2021 Jun 9. doi: 10.1097/MLR.0000000000001576. Online ahead of print.

Abstract

Background: Many ethnic minority women have low attendance at breast cancer screening.

Objectives: This brief report explores whether women's screening histories impact mammography screening attendance after tailored education.

Research design: Systematic searches were conducted in 5 databases. Randomized controlled trials of educational interventions tailored to ethnic minority women that measured attendance at mammography screening were eligible for inclusion. Data extraction and risk of bias assessment were performed independently. Data were combined in a meta-analysis by using random effects models. Heterogeneity was estimated by using I2 statistics.

Results: Six studies with 3521 women were eligible for inclusion. The D+L pooled risk ratio (RR) for mammography attendance for never screened participants was 1.54 (95% confidence interval, 1.24-1.91; P<0.001), with low heterogeneity (I2=27.1%, P=0.231). The D+L pooled risk ratio for attendance for ever screened participants was 1.26 (95% confidence interval, 1.11-1.43; P<0.001), with low heterogeneity (I2=35.5%, P=0.213).

Conclusions: Tailored education increased attendance at mammography by 54% among never screened women and 26% among ever screened women. Although these findings must be interpreted with caution, the findings suggest that women's screening history is an important and ignored variable that affects how effective tailored education is on mammography screening attendance.