{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T07:25:11Z","timestamp":1794036311158,"version":"4.8.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100006662","name":"Ardabil University of Medical Sciences","doi-asserted-by":"publisher","award":["402000610"],"award-info":[{"award-number":["402000610"]}],"id":[{"id":"10.13039\/501100006662","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Breast Cancer Foundation Australia Chair in Breast Cancer Prevention","award":["EC-21-001"],"award-info":[{"award-number":["EC-21-001"]}]},{"name":"National Breast Cancer Foundation Australia Chair in Breast Cancer Prevention","award":["EC-21-001"],"award-info":[{"award-number":["EC-21-001"]}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1194410"],"award-info":[{"award-number":["1194410"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Breast cancer is the most prevalent cancer worldwide and the leading cause of cancer mortality in women. Uptake of breast cancer screening and early-detection practices in low- and middle-income countries (LMIC) has not been synthesized. We aimed to systematically quantify uptake of breast cancer screening in LMIC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a systematic review and meta-analysis of observational population-based studies that reported the uptake of screening or early-detection practices. We searched the PubMed, Scopus, Embase, and Web of Knowledge databases to January 2024. We pooled data using random-effects meta-analysis and explored heterogeneity using subgroup analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 174 population-based studies encompassing more than 78 million women. Pooled prevalence of self-reported uptake of screening mammography was 22.7% (95% confidence interval\u2009=\u200918.6% to 27.2%), of self-reports of having had a clinical breast examination for screening was 23.1% (95% confidence interval\u2009=\u200919.5% to 27.0%), and of self-reported regular breast self-examination (relevant for breast awareness in LMIC) was 14.6% (95% confidence interval\u2009=\u200911.6% to 17.9%). Uptake of breast cancer screening practices was lowest in Africa and low- and lower-middle income countries. Uptake of breast cancer screening practices remained stable over time or decreased slightly. Women who lived in rural area, were single, had lower income levels, had low educational attainment, were unemployed, were uninsured, and had no family history of breast cancer were generally least likely to self-report uptake of breast cancer screening.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This meta-analysis identified concerningly low uptake of breast cancer screening practices in LMIC. Governments should prioritize developing context-appropriate strategies to address this low uptake to support population-level stage shifting of breast cancer in LMIC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jnci\/djae187","type":"journal-article","created":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T06:26:20Z","timestamp":1723271180000},"page":"29-39","source":"Crossref","is-referenced-by-count":22,"title":["Uptake of breast cancer screening practices in low- and middle-income countries: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"117","author":[{"given":"Reza","family":"Ebrahimoghli","sequence":"first","affiliation":[{"name":"Department of Nursing, Institute of Health Education, Ardabil University of Medical Sciences , Ardabil,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0028-7887","authenticated-orcid":false,"given":"Mir Hossein","family":"Aghaei","sequence":"additional","affiliation":[{"name":"Department of Nursing, Institute of Health Education, Ardabil University of Medical Sciences , Ardabil,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saber","family":"Azami-Aghdash","sequence":"additional","affiliation":[{"name":"Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences , Tabriz,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3641-952X","authenticated-orcid":false,"given":"Nehmat","family":"Houssami","sequence":"additional","affiliation":[{"name":"The Daffodil Centre, University of Sydney, joint venture with Cancer Council NSW , Sydney, NSW,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"2025010923571560800_djae187-B1","year":"2020"},{"issue":"3","key":"2025010923571560800_djae187-B2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"issue":"12","key":"2025010923571560800_djae187-B3","doi-asserted-by":"crossref","first-page":"e923","DOI":"10.1016\/S2214-109X(16)30259-5","article-title":"Stage at diagnosis of breast cancer in sub-Saharan Africa: a systematic review and meta-analysis","volume":"4","author":"Jedy-Agba","year":"2016","journal-title":"Lancet Global Health"},{"key":"2025010923571560800_djae187-B4","year":"2023"},{"issue":"4","key":"2025010923571560800_djae187-B5","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/S1470-2045(11)70031-6","article-title":"Optimisation of breast cancer management in low-resource and middle-resource countries: executive summary of the Breast Health Global Initiative consensus, 2010","volume":"12","author":"Anderson","year":"2011","journal-title":"Lancet Oncol"},{"issue":"15","key":"2025010923571560800_djae187-B6","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1001\/jama.2015.13183","article-title":"Benefits and harms of breast cancer screening: a systematic review","volume":"314","author":"Myers","year":"2015","journal-title":"JAMA"},{"key":"2025010923571560800_djae187-B7","doi-asserted-by":"crossref","first-page":"n256","DOI":"10.1136\/bmj.n256","article-title":"Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in Mumbai","volume":"372","author":"Mittra","year":"2021","journal-title":"BMJ"},{"key":"2025010923571560800_djae187-B8","year":"2016"},{"key":"2025010923571560800_djae187-B9","author":"World Bank","year":"2022"},{"key":"2025010923571560800_djae187-B10","doi-asserted-by":"crossref","first-page":"102128","DOI":"10.1016\/j.canep.2022.102128","article-title":"Ethiopian women's breast cancer self-examination practices and associated factors. 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