Breast Cancer Screening among Cancer Survivors: A Systematic Review and Meta-analysis

The objectives of this study were to systematically identify studies that (i) quantified the prevalence of breast cancer screening among female survivors of a prior cancer other than breast cancer and (ii) 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% confidence interval (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 were significantly greater among cancer survivors compared with cancer-free controls (odds ratio: 1.24; 95% CI, 1.13-1.36). Although cancer survivors had higher rates of breast cancer screening compared with 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 nonadherence and explore targeted approaches to improve participation in breast cancer screening among cancer survivors.