Jaques Karla, Baker Thomas, Maharaj Deepak, Fazli Mohammed, Williams Mandy, Harris Patrick
Centre for Health Equity, Training, Research and Evaluation (CHETRE), Part of the International Centre for Future Health Systems, University of New South, South Western Sydney Local Health District Population Health, Liverpool, New South Wales, Australia.
Breast Screen, South Western Sydney Local Health District Population Health, Liverpool, New South Wales, Australia.
Cancer Med. 2025 Apr;14(7):e70817. doi: 10.1002/cam4.70817.
Breast cancer is the most commonly diagnosed cancer in Australia and is the second highest cause of cancer mortality in Australian women. Screening in the form of mammography can significantly reduce mortality; however, research suggests that women from culturally and linguistically diverse (CALD) backgrounds are less likely to participate in mammography screening. While there is an established body of literature describing the lower engagement of CALD populations in screening and the associated challenges they face, less is known about evidence-based interventions to improve engagement.
A systematic scoping review was conducted to gain insights into best practice interventions to improve engagement of CALD populations in breast cancer screening. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. PUBMED, EMBASE and CINHAL databases were searched for studies published between January 2012 and October 2023.
The search yielded 3249 studies; after removing duplicates, 2011 titles and abstracts were screened, and 121 papers underwent full text review. Forty-one were included in the review. Key intervention types were identified, with combination or multi-component studies being most effective at increasing mammography in CALD populations. Cultural appropriateness and tailoring are the most important considerations to be integrated into screening programs.
CALD populations have lower engagement and experience many challenges in accessing screening services. This review found that the integration of cultural appropriateness and tailoring is critical in the successful delivery of breast screening services to CALD populations. Individual strategies are insufficient to engage this population in screening; multicomponent strategies are the most effective.
乳腺癌是澳大利亚最常被诊断出的癌症，也是澳大利亚女性癌症死亡的第二大原因。乳房X光检查形式的筛查可显著降低死亡率；然而，研究表明，来自文化和语言多元（CALD）背景的女性参与乳房X光检查筛查的可能性较小。虽然有大量文献描述了CALD人群在筛查中的参与度较低以及他们面临的相关挑战，但对于提高参与度的循证干预措施了解较少。
进行了一项系统的范围综述，以深入了解提高CALD人群参与乳腺癌筛查的最佳实践干预措施。检索策略遵循系统评价和Meta分析扩展的范围综述首选报告项目（PRISMA-ScR）指南。在PUBMED、EMBASE和CINHAL数据库中检索2012年1月至2023年10月发表的研究。
检索得到3249项研究；去除重复项后，筛选了2011篇标题和摘要，121篇论文进行了全文审查。41篇被纳入综述。确定了关键的干预类型，联合或多成分研究在提高CALD人群的乳房X光检查率方面最有效。文化适宜性和针对性是纳入筛查项目时最重要的考虑因素。
CALD人群参与度较低，在获得筛查服务方面面临诸多挑战。本综述发现，文化适宜性和针对性的整合对于成功向CALD人群提供乳房筛查服务至关重要。个体策略不足以促使该人群参与筛查；多成分策略最有效。
