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We searched Ovid MEDLINE, EMBASE and Cochrane Database of Systematic Reviews (up until 31.12.25). Two reviewers independently screened 20% of titles and abstracts and all full-texts, as well as carried out all AMSTAR 2 assessments to exclude less informative and \u2018critically low\u2019 quality reviews. We extracted information within included reviews on relevant primary studies to conduct random effects meta-analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-three reviews were included, reporting on 168 relevant randomised controlled trials showing significant increases in screening uptake for scheduled versus open appointments (Odds ratio(OR);95% Confidence Intervals(CI)=1.88;1.63,2.17, k=6), advance notification letters versus standard invitation only (OR;95% CI=1.13;1.07,1.20, k=6), letters signed by General Practitioners (OR;95% CI=1.35;1.19,1.53, k=14), educational information (in paper-format) versus no such information (OR;95% CI=1.33;1.05,1.69, k=18), follow-up by calls (OR;95% CI=1.49;1.04,2.14, k=11) or text messages (OR;95% CI=1.28;1.05,1.56, k=7), phone counselling (OR;95% CI=2.63;1.47,4.70, k=4), multi-lingual approaches (OR;95% CI=1.35;1.11,1.63, k=13). Screening uptake was higher in most versus least socially disadvantaged areas for multi-lingual approaches by phone (p=&lt;0.01), follow-up calls (p=&lt;0.01), reminder letters (p=0.03) and \u2018implementation intentions\u2019 (goal-directed plans promoting screening) (p=&lt;0.01). Meta-analyses also showed significant improvements for decision aids (paper-format) on knowledge (OR;95% CI=3.88;1.52,9.93, k=7) and informed choice (OR;95% CI=4.97;1.72,14.35, k=4). Statistical heterogeneity was prevalent, potential publication bias and most studies had high or unclear risks of bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Some effective interventions were identified; however, information on inequalities across outcomes and interventions targeting awareness and help-seeking behaviours were limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748261462921","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T12:25:41Z","timestamp":1783167941000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Improving Breast Cancer Outcomes by Enhanced Activities in Early Detection and Diagnosis: An Umbrella Review and Meta-Analyses of Randomised Controlled Trials in High-Income Contexts With Universal Healthcare 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