Factors associated with participation in colorectal and breast cancer screening among cancer survivors: a systematic review and meta-analysis.

PURPOSE: Cancer survivors are at increased risk of developing subsequent primary cancers, yet participation in recommended cancer screening remains suboptimal. Greater understanding of factors impacting screening participation is needed to inform strategies for improving uptake. Therefore, we aimed to review and quantitatively synthesize predictors of participation in breast cancer (BC) and colorectal cancer (CRC) screening among cancer survivors. METHODS: MEDLINE (Ovid), EMBASE, PubMed, and CINAHL databases were searched from inception through September 2024 to identify studies examining predictors of CRC or BC screening among survivors of other adult cancers. Random effect models were used to estimate pooled associations for predictors reported in ≥ 3 studies. RESULTS: From 2492 initial citations, 49 studies were included, with 35 studies reporting on CRC and 29 on BC screening participation. Factors significantly associated with CRC screening included having a healthcare provider, having health insurance, receiving a provider recommendation for screening, a greater number of physician visits, older age, being a nonsmoker, being married, higher income or education, urban residence, and better mental health. Factors associated with BC screening included receiving a written follow-up care plan, a greater number of physician visits, being married, not having dual Medicaid-Medicare coverage status, receiving specialist care, and White racial identity. CONCLUSIONS: Healthcare access and survivorship care factors appear to play an important role in screening participation among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Interventions addressing barriers to care and social determinants of health may help improve screening uptake and reduce disparities in subsequent cancer screening in this high-risk population.