What factors influence the uptake of bowel, breast, and cervical cancer screening? An overview of international research

Background
For cancer screening programmes to be effective in early detection it is important that those invited can access screening services and understand the benefits of participation. A better understanding of the factors that mater to potential participants of cancer screening programmes can assist in developing strategies to increase uptake and may also be relevant in further understanding and resolving population-based inequalities.
Methods
We conducted an overview of systematic reviews to answer the question: What factors influence the uptake of cancer screening services (breast, bowel, and cervical) in high-income countries? A narrative approach supported by tabular summaries and qualitative heat maps was used to categorise factors, described as ‘barriers’ or ‘facilitators’.
Results A total of 41 systematic reviews met the criteria for inclusion. The barrier with the greatest number of ‘hot spots’ across all three screening programmes was a fear of the unknown regarding a possible diagnosis of cancer or abnormal screening results, followed closely by a general lack of knowledge surrounding cancer screening programmes. The greatest collective facilitator to uptake was recommendation by a healthcare provider to attend screening.
Conclusion
Across all factors ‘trust’ and ‘building trusted relationships’ can be seen as integral to the success of cancer screening programmes and must be reflective of collaborative efforts to mitigate barriers and enhance facilitators to uptake. There is future scope to consider interventions that 1) increase demand for screening services, 2) reduce barriers to uptake of services, and/or 3) are relevant to the healthcare system and those providing services.