Breast cancer screening among cancer survivors: a systematic review and meta-analysis

The objectives of this study were to systematically identify studies that 1) quantified the prevalence of breast cancer screening among female survivors of a prior cancer other than breast cancer and 2) compared the likelihood of undergoing breast cancer screening between cancer survivors and cancer-free controls. Effect estimates were pooled using random effects meta-analyses. Stratified analyses were performed across primary cancer sites with three or more studies. Sixty-two studies were included in this review. The prevalence of breast cancer screening among female cancer survivors was 0.67 (95%CI: 0.62, 0.71), ranging from 0.49 (lung) to 0.75 (cervical) across primary cancer sites. The prevalence of breast cancer screening was higher among studies that ascertained screening through self-report and studies conducted in North America. The odds of undergoing breast cancer screening was significantly greater among cancer survivors compared to cancer-free controls (Odds ratio: 1.24, 95%CI: 1.13-1.36). Although cancer survivors had higher rates of breast cancer screening compared to cancer-free controls, overall rates were below population-based screening targets. Given that cancer survivors are at an elevated risk of subsequent breast cancer, future studies should evaluate predictors of screening non-adherence and explore targeted approaches to improve participation in breast cancer screening among cancer survivors.