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Meta-Analysis
. 2020 Feb;25(1):107-128.
doi: 10.1111/bjhp.12397. Epub 2019 Dec 26.

Health and health belief factors associated with screening and help-seeking behaviours for breast cancer: A systematic review and meta-analysis of the European evidence

Catherine E Grimley  1 , Pamela M Kato  2 , Elizabeth A Grunfeld  3
Affiliations
Meta-Analysis

Health and health belief factors associated with screening and help-seeking behaviours for breast cancer: A systematic review and meta-analysis of the European evidence

Catherine E Grimley et al. Br J Health Psychol. 2020 Feb.

Abstract

Purpose: The aim of this systematic review was to identify health or health belief factors associated with mammography attendance or with self-initiated medical help-seeking for breast cancer symptoms among women in Europe.

Methods: Five databases were searched for articles published between 2005 and 2018. Meta-analyses were conducted for 13 factors related to screening attendance and two factors associated with help-seeking behaviour. Where there were too few studies to include in the meta-analysis, a narrative synthesis was undertaken.

Results: Sixty-five studies were included. Never having had cervical screening (d = -.72, p < .001) and higher perceived barriers to mammography (d = -.40, p < .001) were associated with lower levels of screening attendance. Possessing health insurance (d = .49, p < .001), greater perceived benefits (d = .31, p < .001) and motivation (d = .36, p = .003) towards screening, and higher perceived seriousness (d = .24, p = .019) and susceptibility (d = .20, p = .024) towards breast cancer were associated with a higher level of screening attendance. Presenting with a non-lump symptom was associated with a longer time to presentation (d = .32, p < .001). The narrative synthesis revealed that previous benign breast disease was associated with a higher level of screening attendance but with a longer time to presentation.

Conclusions: The review identified key similarities in factors associated with screening and help-seeking behaviours which offer scope for combined interventions aimed at women that target both behaviours. Furthermore, the review highlighted that fewer studies have focused on help-seeking behaviour, despite two thirds of breast cancer cases being self-detected. Future research should further examine predictors of help-seeking behaviour including a focus on modifiable factors, such as BMI, and physical activity.

Keywords: breast cancer; help-seeking; mammography; meta-analysis; screening.

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References

    1. **Acikgoz, A., & Ergor, G. (2013). Compliance with screening recommendations according to breast cancer risk levels in Izmir, Turkey. Asian Pacific Journal of Cancer Prevention, 14, 1737-1742. https://doi.org/10.7314/APJCP.2013.14.3.1737
    1. Aiken, L. S., West, S. G., Woodward, C. K., & Reno, R. R. (1994). Health beliefs and compliance with mammography-screening recommendations in asymptomatic women. Health Psychology, 13(2), 122-129. https://doi.org/10.1037/0278-6133.13.2.122
    1. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-t
    1. Alhurishi, S., Lim, J. N. W., Potrata, B., & West, R. (2011). Factors influencing late presentation for breast cancer in the middle east: A systematic review. Asian Pacific Journal of Cancer Prevention, 12, 1597-1600.
    1. **Anagnostopoulos, F., Dimitrakaki, C., Fitzsimmons, D., Potamianos, G., Niakas, D., & Tountas, Y. (2012). Health beliefs and illness perceptions as related to mammography uptake in randomly selected women in Greece. Journal of Clinical Psychology in Medical Settings, 19(2), 147-164. https://doi.org/10.1007/s10880-011-9272-1

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