Association between comorbidity and participation in breast and cervical cancer screening

A systematic review and meta-analysis

Abbey Diaz, Jimin Kang, Suzanne P. Moore, Peter Baade, Danette Langbecker, John R. Condon, Patricia C. Valery

    Research output: Contribution to journalReview articleResearchpeer-review

    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.

    Original languageEnglish
    Pages (from-to)7-19
    Number of pages13
    JournalCancer Epidemiology
    Volume47
    DOIs
    Publication statusPublished - Apr 2017

    Fingerprint

    Early Detection of Cancer
    Uterine Cervical Neoplasms
    Meta-Analysis
    Comorbidity
    Breast Neoplasms
    Breast
    Mammography
    PubMed
    Odds Ratio
    Databases
    Research
    Population
    Neoplasms

    Cite this

    @article{e164c35fae2c463793d40ae4f0b68dc7,
    title = "Association between comorbidity and participation in breast and cervical cancer screening: A systematic review and meta-analysis",
    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.",
    keywords = "Breast neoplasms, Cancer screening, Cervical neoplasms, Chronic disease, Comorbidity, Early detection of cancer, Mammography, Meta-analysis, Multimorbidity, Papanicolaou test",
    author = "Abbey Diaz and Jimin Kang and Moore, {Suzanne P.} and Peter Baade and Danette Langbecker and Condon, {John R.} and Valery, {Patricia C.}",
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    language = "English",
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    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.; Valery, Patricia C.

    In: Cancer Epidemiology, Vol. 47, 04.2017, p. 7-19.

    Research output: Contribution to journalReview articleResearchpeer-review

    TY - JOUR

    T1 - Association between comorbidity and participation in breast and cervical cancer screening

    T2 - A systematic review and meta-analysis

    AU - Diaz, Abbey

    AU - Kang, Jimin

    AU - Moore, Suzanne P.

    AU - Baade, Peter

    AU - Langbecker, Danette

    AU - Condon, John R.

    AU - Valery, Patricia C.

    PY - 2017/4

    Y1 - 2017/4

    N2 - 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.

    AB - 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.

    KW - Breast neoplasms

    KW - Cancer screening

    KW - Cervical neoplasms

    KW - Chronic disease

    KW - Comorbidity

    KW - Early detection of cancer

    KW - Mammography

    KW - Meta-analysis

    KW - Multimorbidity

    KW - Papanicolaou test

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    U2 - 10.1016/j.canep.2016.12.010

    DO - 10.1016/j.canep.2016.12.010

    M3 - Review article

    VL - 47

    SP - 7

    EP - 19

    JO - Cancer Epidemiology

    JF - Cancer Epidemiology

    SN - 0361-090X

    ER -