Abstract
BackgroundMultiple reviews demonstrated high variability in effectiveness and cost-effectiveness outcomes among studies on breast cancer screening (BCS) programmes. No study to our knowledge has summarized the current evidence on determinants of effectiveness and cost-effectiveness of the most used BCS approaches or tried to explain differences in conclusions of systematic reviews on this topic. Based on published reviews, this systematic review aims to assess the degree of variability of determinants for (a) effectiveness and (b) cost-effectiveness of BCS programmes using mammography, clinical breast examination, breast self-examination, ultrasonography, or their combinations among the general population.MethodsWe will perform a comprehensive systematic literature search in Cochrane, Scopus, Embase, and Medline (via Pubmed). The search will be supplemented with hand searching of references of the included reviews, with hand searching in the specialized journals, and by contacting prominent experts in the field. Additional search for grey literature will be conducted on the websites of international cancer associations and networks. Two trained research assistants will screen titles and abstracts of publications independently, with at least random 10% of all abstracts being also screened by the principal researcher. The full texts of the systematic reviews will then be screened independently by two authors, and disagreements will be solved by consensus. The included reviews will be grouped by publication year, outcomes, designs of original studies, and quality. Additionally, for reviews published since 2011, transparency in reporting will be assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for the review on determinants of effectiveness and a modified PRISMA checklist for the review on determinants for cost-effectiveness. The study will apply the Assessing the Methodological Quality of Systematic Reviews checklist to assess the methodological quality of systematic reviews. We will report the data extracted from the systematic reviews in a systematic format. Meta-meta-analysis of extracted data will be conducted when feasible.DiscussionThis systematic review of reviews will examine the degree of variability in the effectiveness and cost-effectiveness of BCS programmes.Systematic review registrationPROSPERO CRD42016050764 and CRD42016050765
Highlights
Multiple reviews demonstrated high variability in effectiveness and cost-effectiveness outcomes among studies on breast cancer screening (BCS) programmes
The International Agency for Research on Cancer and the US Preventive Service Task Force conclude on sufficient evidence regarding the benefits of mammography for 50–74-year-old women [3, 4], the European Society for Medical Oncology (ESMO) [2] for 50–69 years old, the American Cancer Society [5] from the age of 45 and continuing after 69 if life expectancy is more than 10 years, and the UK National Health Service for women aged 50 to 70 years old every 3 years [6]
Despite many reviews evaluating the quality of included studies, to our knowledge, no study has summarized the current evidence on the determinants of effectiveness and cost-effectiveness of routinely used BCS approaches or explored the possible differences in the conclusions of systematic reviews on this topic
Summary
We will perform a comprehensive systematic literature search in Cochrane, Scopus, Embase, and Medline (via Pubmed). Additional search for grey literature will be conducted on the websites of international cancer associations and networks. Two trained research assistants will screen titles and abstracts of publications independently, with at least random 10% of all abstracts being screened by the principal researcher. The full texts of the systematic reviews will be screened independently by two authors, and disagreements will be solved by consensus. The included reviews will be grouped by publication year, outcomes, designs of original studies, and quality. The study will apply the Assessing the Methodological Quality of Systematic Reviews checklist to assess the methodological quality of systematic reviews. We will report the data extracted from the systematic reviews in a systematic format. Meta-meta-analysis of extracted data will be conducted when feasible
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