Exploring the influence of rural residence on uptake of organized cancer screening: a systematic review of international literature

Lauren T Walji* (Corresponding Author), Peter Murchie, Gerald Lip, Valerie Speirs, Lisa Iversen

*Corresponding author for this work

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6 Citations (Scopus)
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Lower screening uptake could impact cancer survival in rural areas. This systematic review sought studies comparing rural/urban uptake of colorectal, cervical and breast cancer screening in high income countries. Relevant studies (n=50) were identified systematically by searching Medline, EMBASE and CINAHL. Narrative synthesis found that screening uptake for all three cancers was
generally lower in rural areas. In meta-analysis, colorectal cancer screening uptake (OR 0.66, 95% CI=0.50-0.87, I 2 = 85%) was significantly lower for rural dwellers than their urban counterparts. The meta-analysis found no relationship between uptake of breast cancer screening and rural versus urban residency (OR 0.93, 95% CI=0.80-1.09, I2=86%). However, it is important to note the limitation of the significant statistical heterogeneity found which demonstrates the lack of
consistency between the few studies eligible for inclusion in the meta-analyses. Cancer screening uptake is apparently lower for rural dwellers which may contribute to poorer survival. National screening programmes should consider geography in planning.
Original languageEnglish
Article number101995
Number of pages17
JournalCancer Epidemiology
Early online date17 Aug 2021
Publication statusPublished - Oct 2021

Bibliographical note

LW is a final year medical student and this work was completed as part of LW’s intercalated Bachelors of Science degree at the University of Aberdeen. A small grant from the University of Aberdeen and NHS Grampian Endowment Research Grant (19/026) supported literature retrieval. We thank Melanie Bickerton (MB) (Medical librarian) for assistance with the development of the search strategy.


  • Cancer
  • Screening
  • epidemic
  • Geographic
  • Review


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