Exploring the influence of rural residence on uptake of organized cancer screening: a systematic review of international literature

Lower screening uptake could impact cancer survival in rural areas. This systematic review sought studies comparing rural/urban uptake of colorectal, cervical and breast cancer screening in high income countries. Relevant studies (n=50) were identified systematically by searching Medline, EMBASE and CINAHL. Narrative synthesis found that screening uptake for all three cancers was
generally lower in rural areas. In meta-analysis, colorectal cancer screening uptake (OR 0.66, 95% CI=0.50-0.87, I 2 = 85%) was significantly lower for rural dwellers than their urban counterparts. The meta-analysis found no relationship between uptake of breast cancer screening and rural versus urban residency (OR 0.93, 95% CI=0.80-1.09, I2=86%). However, it is important to note the limitation of the significant statistical heterogeneity found which demonstrates the lack of
consistency between the few studies eligible for inclusion in the meta-analyses. Cancer screening uptake is apparently lower for rural dwellers which may contribute to poorer survival. National screening programmes should consider geography in planning.