{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:01:14Z","timestamp":1785477674214,"version":"3.56.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical breast examination (CBE) is a feasible early-detection method in low-resource settings, but critical gaps remain regarding its uptake in sub-Saharan Africa. We estimated the prevalence of CBE uptake and synthesized multilevel factors associated with uptake, organized within a socio-ecological framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a PRISMA-guided systematic review and meta-analysis of cross-sectional studies assessing self-reported CBE uptake. PubMed, Embase, Web of Science, CINAHL, Africa-Wide Information, Google Scholar, and gray literature were searched. Random-effects meta-analysis was used to pool prevalence estimates and adjusted odds ratios for determinants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pooled prevalence of CBE uptake was 13% (95% CI, 9-18%). Pooled determinant analyses showed that higher educational attainment, greater household wealth, health insurance coverage, and recent health-facility contact were associated with higher CBE uptake. Internet use, radio listening, and rural residence were not statistically significant in the pooled analysis. Additional non-pooled findings suggested that age, breast cancer awareness, breast self-examination, reproductive and maternal health-service contact, and empowerment-related factors are also associated with CBE uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CBE uptake in sub-Saharan Africa is low and socioecologically patterned, underscoring the need for integrated, equity-focused early detection strategies at the individual, community, and health-system levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1856988","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:39:37Z","timestamp":1785476377000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and multilevel factors associated with clinical breast examination uptake among women in sub-Saharan Africa: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Silas Selorm","family":"Daniels-Donkor","sequence":"first","affiliation":[{"name":"Department of Nursing Research, University of Virginia School of Nursing","place":["Charlottesville, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Datesman","sequence":"additional","affiliation":[{"name":"Department of Nursing Research, University of Virginia School of Nursing","place":["Charlottesville, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha Do","family":"Byon","sequence":"additional","affiliation":[{"name":"Department of Nursing Research, University of Virginia School of Nursing","place":["Charlottesville, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald Babamomba","family":"Amenah","sequence":"additional","affiliation":[{"name":"Department of Family and Community Health, University of Maryland School of Nursing","place":["Baltimore, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basiru","family":"Dawda","sequence":"additional","affiliation":[{"name":"Department of Nursing Research, University of Virginia School of Nursing","place":["Charlottesville, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly J.","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Nursing Research, University of Virginia School of Nursing","place":["Charlottesville, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma M.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Nursing Research, University of Virginia School of Nursing","place":["Charlottesville, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"B1","unstructured":"Ferlay\n              J\n            \n            \n              Ervik\n              M\n            \n            \n              Lam\n              F\n            \n            \n              Laversanne\n              M\n            \n            \n              Colombet\n              M\n            \n            \n              Mery\n              L\n            \n          \n          Global Cancer Observatory. 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