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Cited by 0Global Cancer Incidence and ScreeningWomen's cancer prevention and managementColorectal Cancer Screening and Detection

Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review

Open access
Palsola, Minttu, Likki, Tiina, Snijders, Veerle, Corbex, Marilys, Lasierra, Losada, Curtis, Benjamin·2026·Glasnik javnog zdravlja
DOI 10.5937/serbjph2601086p
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Abstract

Population-based cancer screening programmes can significantly reduce cervix, breast and colorectal cancer mortality and morbidity. While many countries have set up screening programs for these cancers, people do not always use them. It is vital to understand why people do (not) get screened to better plan effective interventions. This paper presents a rapid review of research to identify (1) common barriers and drivers to undergoing screening and (2) intervention components used to increase screening rates. Selection criteria for the review included English-language studies published 2000-2024. To be included for barriers and drivers of cancer screening attendance, studies had to address the factors why people do (not) attend screenings. To be included for interventions, studies had to assess interventions aiming to increase screening. Quantitative and qualitative studies were eligible. The research presented here focuses primarily though not exclusively on evidence from the WHO European Region. Barriers and drivers are categorised according to the COM-B model, namely capability, opportunity, and motivation-related factors. Key capability barriers included limited awareness, low health literacy, and forgetfulness; motivational barriers included negative beliefs, fatalism, and emotional factors such as fear, shame, or disgust; opportunity-related barriers encompassed cost, access constraints, time limitations, and sociocultural stigma. Drivers included perceived benefits, high self-efficacy, supportive provider communication, and social encouragement. Effective interventions were typically multicomponent, combining educational and access-enhancing elements. Educational strategies were most successful when interactive, culturally tailored, and skill-focused. Invitations and reminders, particularly personalised, physician-signed, or opt-out formats, improved attendance. Organisational changes-such as designated screening clinics, nonphysician-led delivery, and quality improvement systems-consistently enhanced uptake. Patient navigation and community-based approaches were beneficial for underserved groups. Home-testing facilitated colorectal and cervical screening participation when logistical barriers were minimised. Cancer screening uptake is shaped by intertwined behavioural, structural, and cultural factors. Interventions that address multiple COM-B domains-improving knowledge, motivation, accessibility, and cultural appropriateness-show the greatest promise. Tailoring strategies to local contexts and population needs is critical to achieving equitable screening coverage and reducing preventable cancer burden.

AI snapshot

Written from the paper’s full text.

TL;DR

This rapid review synthesises barriers and drivers of cervical, breast, and colorectal cancer screening and intervention components to increase uptake, primarily in the WHO European Region. It finds that effective interventions are typically multicomponent, combining educational and access-enhancing elements, and should be tailored to context-specific COM-B barriers.

Key findings

  • The review identified 55 English-language articles, of which 19 were systematic reviews or meta-analyses. Barriers and drivers were mapped to COM-B: capability barriers included limited awareness, low health literacy, and forgetfulness; motivational barriers included negative beliefs, fatalism, and emotions such as fear, shame, or disgust; opportunity barriers included cost, access constraints, time limitations, and sociocultural stigma. Drivers included perceived benefits, high self-efficacy, supportive provider communication, and social encouragement.
  • Intention explained 27% of actual screening uptake; odds of getting screened with intention were OR 1.8 for cervical cancer and OR 1.72 for breast cancer compared with no intention.
  • Invitations and reminders improved attendance: a fixed appointment increased mammography participation to 22% versus 12% for free booking; stepwise/multimodal reminders in Portugal achieved 51% versus 34% for letter only; a prompt to write down the date increased colorectal cancer screening by 8 percentage points in Spain; and an “if-then” leaflet increased adherence by 1.2–6.6%, reaching 71.4% versus 67.9% in the last six-month wave.
  • Home testing facilitated colorectal and cervical screening: including a test kit in the invitation doubled the likelihood of colorectal cancer screening participation in Belgium, with a modest impact in Italy (63.0% vs 56.8%). Organisational changes, patient navigation, and community-based approaches benefited underserved groups; however, highlighting benefits had adverse effects in Spain, decreasing participation by 10.7% among newly invited individuals.

Methods

  • Rapid review of English-language studies published 2000–2024. The lead author searched Medline, PsycINFO, Web of Science, Scopus, PubMed.gov, and CINAHL, with snowballing of references. Quantitative and qualitative studies were eligible. The search focused primarily but not exclusively on the WHO European Region; individual studies from conflict areas or weak health systems were excluded case-by-case where access difficulties mainly hampered screening.
  • Barriers and drivers were deductively categorised under an adapted COM-B model; interventions were inductively categorised by identified features. Systematic reviews and meta-analyses were screened first, followed by other reviews, RCTs, and other individual studies; the review was halted at information saturation. Initial review and categorisation were done by a WHO consultant and reviewed by WHO Behavioural and Cultural Insights team members.

Limitations

  • Stated: as a rapid review rather than a systematic review, it may not have captured all relevant aspects; inclusion and quality were assessed by one reviewer, risking selection bias; the WHO European Region focus limits generalisability; most intervention studies do not describe which barriers they target or how, so the review cannot explain what drove effects; there are no comparisons of effectiveness between studies; publication bias may affect conclusions; search terms limited the study; and the review does not consider intervention cost or participant engagement, so comparative cost-effectiveness needs separate investigation.
  • Evident from the text: effectiveness conclusions are narrative and cautious rather than pooled or formally meta-analysed, and the authors repeatedly advise caution in drawing effectiveness conclusions.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.5937/serbjph2601086p

Cites

63 of 63 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

127 of 216 cited sources checked · 71 supported · 4 flagged · accuracy not yet measured

  • Findingcitation

    Motivation is positively associated with screening attendance.

    “Motivation has been positively associated with screening attendance [9,14,17,18].”
    Quote in the paperSubstantial claim2 of 4 sources checked
    • cites [9] Honein-AbouHaidar GN, Kastner M, Vuong V, Perrier L, Daly C, Rabeneck L et al. Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev. 2016; 25:907-17. https://doi.org/10.1158/1055-9965.EPI-15-0990; source
    • cites [14] Ritchie D, Van den Broucke S, Van Hal G. The health belief model and theory of planned behavior applied to mammography screening: A systematic review and meta-analysis. Public Health Nurs. 2021; 38(3):482-92. https://doi.org/10.1111/phn.12842; source

      The review and meta-analysis (p. 11) reports that health motivation was negatively, not positively, associated with mammography screening behavior (OR 0.94; 95% CI 0.89–1.00). It separately reports a positive association for intention, which is a different construct. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites [17] Grimley CE, Kato PM, Grunfeld EA. Health and health belief factors associated with screening and help-seeking behaviours for breast cancer: A systematic review and meta-analysis of the European evidence. Br J Health Psychol. 2020; 25(1):107-28. https://doi.org/10.1111/bjhp.12397; source
    • cites [18] Talley CH, Yang L, Williams KP. Breast Cancer Screening Paved with Good Intentions: Application of the Information-Motivation-Behavioral Skills Model to Racial/Ethnic Minority Women. J Immigr Minor Health. 2017; 19(6):1362-71. https://doi.org/10.1007/s10903-016-0355-9; source
  • Findingcitation

    Positive attitudes towards cancer screening are associated with increased BC and CC screening.

    “In systematic reviews comparing different health behaviour theory constructs, positive attitudes towards cancer screening have been associated with increased BC and CC screening [11,14].”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [11] Dsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. The application of health behavior theories to promote cervical cancer screening uptake. Public Health Nurs. 2021; 38(6):1039-79. https://doi.org/10.1111/phn.12944; source
    • cites [14] Ritchie D, Van den Broucke S, Van Hal G. The health belief model and theory of planned behavior applied to mammography screening: A systematic review and meta-analysis. Public Health Nurs. 2021; 38(3):482-92. https://doi.org/10.1111/phn.12842; source

      The HBM & TPB: Review & Meta-analysis section (p. 11) reports the opposite direction for breast-cancer mammography screening: attitudes had a mean odds ratio of 0.98 and were described as negatively associated with screening behavior. The paper addresses mammography screening, not cervical-cancer screening, so it does not establish the cervical-cancer part of the claim. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Findingcitation

    Compared to reminder letters, phone calls to non-responders after the initial letter increased screening.

    “Compared to reminder letters, phone calls to non-responders after the initial letter increased screening [51].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [51] Musa J, Achenbach CJ, O'Dwyer LC, Evans CT, McHugh M, Hou L et al. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis. PloS One. 2017; 12(9):e0183924. https://doi.org/10.1371/journal.pone.0183924; source

      The Results section reports that, among women who did not respond to an initial screening invitation, telephone reminders did not significantly increase screening uptake compared with mailed reminder letters (6.5% vs 5.8%). Other positive findings in the review used different comparators, such as no phone reminder or usual care. (LLM, conf=0.90)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Findingcitation

    In the United Kingdom, misunderstanding instructions for CRC home-testing was a barrier for people with low socio-economic status.

    “In the United Kingdom however, misunderstanding instructions for CRC home-testing was a barrier for people with low socio-economic status [8].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [8] Dharni N, Armstrong D, Chung-Faye G, Wright AJ. Factors influencing participation in colorectal cancer screening-a qualitative study in an ethnic and socio-economically diverse inner city population. Health Expect. 2017; 20:608-17. http://doi.org/10.1111/hex.12489; source
  • Findingcitation

    Lack of knowledge of screening programmes can be a barrier to CRC screening.

    “the lack of knowledge of screening programmes [7] can be barriers to screening.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [7] Bongaerts TH, Büchner FL, Middelkoop BJ, Guicherit OR, Numans ME. Determinants of (non-)attendance at the Dutch cancer screening programmes: A systematic review. J Med Screen. 2020; 27:121-9. https://doi.org/10.1177/0969141319887996; source
  • May combine two claims. 46
  • Classified as probably not a substantial claim. 22

  • May combine two claims.

    Findingcitation

    In systematic reviews, perceived control in personal health choices and high self-efficacy to attend screening are positively associated with screening.

    “In systematic reviews, perceived control in personal health choices and high self-efficacy to attend screening have been positively associated with screening [7,10,11,14].”
    Quote in the paperSubstantial claim3 of 4 sources checked
    • cites [7] Bongaerts TH, Büchner FL, Middelkoop BJ, Guicherit OR, Numans ME. Determinants of (non-)attendance at the Dutch cancer screening programmes: A systematic review. J Med Screen. 2020; 27:121-9. https://doi.org/10.1177/0969141319887996; source

      The Results (Motivational factors; page unavailable) identify self-efficacy as an important determinant of colorectal cancer screening attendance, and Table 3 lists low self-efficacy among determinants of non-attendance. Our copy does not report an association between perceived control over personal health choices and screening. The self-efficacy finding is also specific to colorectal screening in the Dutch programmes reviewed. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [10] Vallone F, Lemmo D, Martino ML, Donizzetti AR, Freda MF, Palumbo F et al. Factors promoting breast, cervical and colorectal cancer screenings participation: A systematic review. Psychooncology. 2022; 31(9):1435-47. https://doi.org/10.1002/pon.5997; source
    • cites [11] Dsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. The application of health behavior theories to promote cervical cancer screening uptake. Public Health Nurs. 2021; 38(6):1039-79. https://doi.org/10.1111/phn.12944; source
    • cites [14] Ritchie D, Van den Broucke S, Van Hal G. The health belief model and theory of planned behavior applied to mammography screening: A systematic review and meta-analysis. Public Health Nurs. 2021; 38(3):482-92. https://doi.org/10.1111/phn.12842; source

      The meta-analysis reports perceived behavioral control as negatively, not positively, associated with mammography screening behavior (p. 11; OR 0.99, 95% CI 0.96–1.02). The Background (p. 4) defines self-efficacy as confidence to act but does not report that high self-efficacy is positively associated with screening. (LLM, conf=0.86)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationcitation

    Awareness/knowledge can be viewed as a requisite for attendance and as central in influencing other factors.

    “Awareness/knowledge can be viewed as a requisite for attendance [10] and as central in influencing other factors.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [10] Vallone F, Lemmo D, Martino ML, Donizzetti AR, Freda MF, Palumbo F et al. Factors promoting breast, cervical and colorectal cancer screenings participation: A systematic review. Psychooncology. 2022; 31(9):1435-47. https://doi.org/10.1002/pon.5997; source

      The Results section (“Knowledge and awareness”; page unavailable) says high knowledge and awareness promote cancer-screening attendance, mainly among first-time attenders. It does not establish that knowledge or awareness is a requisite for attendance. The citation is attached to that requisite claim, not to the sentence’s separate assertion about influencing other factors. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationcitation

    These aspects are especially important in encouraging information-seeking related to cancer screening and increasing willingness to overcome barriers.

    “These aspects are especially important in encouraging information-seeking related to cancer screening, and increasing the willingness to overcome barriers [10].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [10] Vallone F, Lemmo D, Martino ML, Donizzetti AR, Freda MF, Palumbo F et al. Factors promoting breast, cervical and colorectal cancer screenings participation: A systematic review. Psychooncology. 2022; 31(9):1435-47. https://doi.org/10.1002/pon.5997; source

  • May combine two claims.

    Findingcitation

    Fear of screening results is a commonly reported barrier and relates to the view of cancer being deadly.

    “Fear of screening results is a commonly reported barrier, relating to the view of cancer being deadly [10].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] Vallone F, Lemmo D, Martino ML, Donizzetti AR, Freda MF, Palumbo F et al. Factors promoting breast, cervical and colorectal cancer screenings participation: A systematic review. Psychooncology. 2022; 31(9):1435-47. https://doi.org/10.1002/pon.5997; source

  • May combine two claims.

    Findingcitation

    Accessibility barriers include long distances and lack of access to healthcare services.

    “Accessibility barriers include long distances and lack of access to healthcare services [10] as well as lack of transportation and difficulties in finding an escort for older adults [9].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] Vallone F, Lemmo D, Martino ML, Donizzetti AR, Freda MF, Palumbo F et al. Factors promoting breast, cervical and colorectal cancer screenings participation: A systematic review. Psychooncology. 2022; 31(9):1435-47. https://doi.org/10.1002/pon.5997; source

  • May combine two claims.

    Findingcitation

    Non-attenders reported negative role models and talked less with other people about cancer screening.

    “In a Dutch review, non-attenders reported experiencing greater negative social influences than attenders.They reported negative role models (e.g., close friends or family members not attending screenings) and talked less with other people about cancer screening [7].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [7] Bongaerts TH, Büchner FL, Middelkoop BJ, Guicherit OR, Numans ME. Determinants of (non-)attendance at the Dutch cancer screening programmes: A systematic review. J Med Screen. 2020; 27:121-9. https://doi.org/10.1177/0969141319887996; source

  • May combine two claims.

    Findingcitation

    Awareness raising usually relies on one-way information provision through small media (booklets, videos, letters) and less often mass media.

    “Awareness raising usually relies on one-way information provision through small media e.g., booklets, videos, letters [9,38,39], and less often mass media [38].”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [9] Honein-AbouHaidar GN, Kastner M, Vuong V, Perrier L, Daly C, Rabeneck L et al. Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev. 2016; 25:907-17. https://doi.org/10.1158/1055-9965.EPI-15-0990; source
    • cites [38] Brouwers MC, De Vito C, Bahirathan L, Carol A, Carroll JC, Cotterchio M et al. What implementation interventions increase cancer screening rates? a systematic review. Implement Sci. 2011; 6:111. https://doi.org/10.1186/1748-5908-6-111; source

      The Methods table defines small media as videos and printed materials including letters, brochures and pamphlets. The Results report 23 eligible small-media trials and no eligible trials of mass media alone, but caution that mass-media studies may use other designs. This does not establish that awareness raising usually uses one-way communication or that mass media is used less often in practice. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • cites [39] Everett T, Bryant A, Griffin MF, Martin-Hirsch PP, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev. 2011; 2011(5):CD002834. https://doi.org/10.1002/14651858.CD002834.pub2; source

      The Results (Description of studies; page not provided) describe 17 trials of invitation letters and three of printed educational materials, while the Results (Effects of interventions; page not provided) describe a television-media trial. This supports the examples of letters and printed materials and suggests less coverage of mass media in this review. It does not establish that awareness raising usually relies on one-way provision, or specifically identify videos as a commonly used small medium. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationcitation

    Excessive information may be burdening, especially if it is not clearly from a trusted source such as a local health clinic.

    “This suggests that excessive information may be burdening -especially if it is not clearly from a trusted source, e.g., a local health clinic [40].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [40] Goodwin BC, Ireland MJ, March S, Myers L, Crawford-Williams F, Chambers SK et al. Strategies for increasing participation in mail-out colorectal cancer screening programs: a systematic review and meta-analysis. Syst Rev. 2019; 8(1):257. https://doi.org/10.1186/s13643-019-1170-x; source

      The Discussion (page unavailable) says that added narrative information may burden and deter participation in mail-out colorectal screening, and that the source of printed content appeared to matter more than its content. It also describes GPs as trusted sources of medical advice. It does not establish that excessive information is especially burdensome when its source is unclear, or specifically assess a local health clinic as the source. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    No significant difference has been found between mixed versus face-to-face contact and face-to-face versus remote contact.

    “nificant difference has been found between mixed versus face-to-face contact and face-to-face versus remote contact [43].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [43] Tsipa A, O'Connor DB, Branley-Bell D, Day F, Hall LH, Sykes-Muskett B et al. Promoting colorectal cancer screening: a systematic review and meta-analysis of randomised controlled trials of interventions to increase uptake. Health Psychol Rev. 2021; 15(3):371-94. https://doi.org/10.1080/17437199.2020.1760726; source

  • May combine two claims.

    Interpretationcitation

    Addressing structural and motivational barriers may be essential to raising participation rates as knowledge does not always translate into action.

    “Addressing structural and motivational barriers may be essential to raising participation rates as knowledge does not always translate into action [9, 44, 51, 65].”
    Quote in the paperSubstantial claim2 of 4 sources checked
    • cites [9] Honein-AbouHaidar GN, Kastner M, Vuong V, Perrier L, Daly C, Rabeneck L et al. Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev. 2016; 25:907-17. https://doi.org/10.1158/1055-9965.EPI-15-0990; source
    • cites [44] Al-Oseely SA, Manaf RA, Ismail S. A Systematic Evaluation of Methods Used and the Effectiveness of Health Education Interventions to Improve Knowledge, Beliefs, and Practices of Cervical Cancer Screening. Malays J Med Health Sci 2021; 17(3):259-67. Available online: https://medic.upm.edu.my/upload/dokumen/2021062816042937_MJMHS_1042.pdf;

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [51] Musa J, Achenbach CJ, O'Dwyer LC, Evans CT, McHugh M, Hou L et al. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis. PloS One. 2017; 12(9):e0183924. https://doi.org/10.1371/journal.pone.0183924; source
    • cites [65] Hombaiah C, Madhu B, Gopi A, Narayana Murthy MR. Effects of mobile Health (mHealth) application on cervical cancer prevention knowledge and screening among women social support groups with low-socioeconomic status in Mysuru city, Southern India. PLoS ONE. 2022; 17(9):e0273070. https://doi.org/10.1371/journal.pone.0273070; source

      The Results (page not available in our copy) show that knowledge improved significantly after the mHealth intervention, while Pap-test participation rose from 4.9% to 8.8% without a statistically significant change. This supports the point that knowledge does not always translate into screening, but the paper does not identify structural or motivational barriers or test whether addressing them raises participation. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Interpretationcitation

    Social supports facilitate self-efficacy, which in turn is associated with screening attendance.

    “Such supports are important because they facilitate self-efficacy, which in turn is associated with screening attendance [7,10,11,14].”
    Quote in the paperSubstantial claim3 of 4 sources checked
    • cites [7] Bongaerts TH, Büchner FL, Middelkoop BJ, Guicherit OR, Numans ME. Determinants of (non-)attendance at the Dutch cancer screening programmes: A systematic review. J Med Screen. 2020; 27:121-9. https://doi.org/10.1177/0969141319887996; source

      The Results (Motivational factors; page unavailable) identify self-efficacy as a determinant of colorectal screening attendance and report that cervical-screening non-attenders experienced more negative social influences. The review does not establish the claimed link that social supports facilitate self-efficacy; its Discussion treats social influence and self-efficacy as separate influences on motivation. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites [10] Vallone F, Lemmo D, Martino ML, Donizzetti AR, Freda MF, Palumbo F et al. Factors promoting breast, cervical and colorectal cancer screenings participation: A systematic review. Psychooncology. 2022; 31(9):1435-47. https://doi.org/10.1002/pon.5997; source

      The Results (Research question one; page not provided) identify high perceived self-efficacy as a factor promoting screening adherence and report that talking with family and friends can promote screening. The review does not say that social support facilitates self-efficacy, so it does not establish the claimed link between them. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [11] Dsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. The application of health behavior theories to promote cervical cancer screening uptake. Public Health Nurs. 2021; 38(6):1039-79. https://doi.org/10.1111/phn.12944; source
    • cites [14] Ritchie D, Van den Broucke S, Van Hal G. The health belief model and theory of planned behavior applied to mammography screening: A systematic review and meta-analysis. Public Health Nurs. 2021; 38(3):482-92. https://doi.org/10.1111/phn.12842; source

      The Background (p. 4) identifies self-efficacy as a health-belief-model construct, and the review (p. 5) describes perceived behavioral control as serving a similar function. But the paper does not say that social supports facilitate self-efficacy; its reported association between perceived behavioral control and mammography screening behavior is weak and negative (p. 11), not evidence for the proposed pathway to attendance. (LLM, conf=0.77)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    Reminders have been effective, but more for previously compliant attenders than for non-attenders.

    “Reminders have also been effective [42], but more for previously compliant attenders than for non-attenders [35].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [42] Stone EG, Morton SC, Hulscher ME, Maglione MA, Roth EA, Grimshaw JM et al. Interventions That Increase Use of Adult Immunization and Cancer Screening Services. Ann Intern Med. 2002; 136(9):641-51. https://doi.org/10.7326/0003-4819-136-9-200205070-00006; source
    • cites [35] Prusaczyk A, Zuk P, Guzek M, Bogdan M, Nitsch-Osuch A, Oberska J et al. An overview of factors influencing cancer screening uptake in primary healthcare institutions. Fam Med Prim Care Rev. 2022; 24(1):71-7. https://doi.org/10.5114/fmpcr.2022.113019; source

  • May combine two claims.

    Findingcitation

    Understanding the patients' perspective, addressing patients' needs and involving patients in the decision-making were associated with increased CRC screening.

    “Understanding the patients' perspective, addressing patients' needs and involving patients in the decision-making were associated with increased CRC screening [59].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [59] Underhill ML, Kiviniemi MT. The association of perceived provider-patient communication and relationship quality with colorectal cancer screening. Health Educ Behav. 2012; 39(5):555-63. https://doi.org/10.1177/1090198111421800; source

  • May combine two claims.

    Findingcitation

    These prompts also increased CC and BC screening.

    “These prompts also increased CC [11] and BC screening [57].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [11] Dsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. The application of health behavior theories to promote cervical cancer screening uptake. Public Health Nurs. 2021; 38(6):1039-79. https://doi.org/10.1111/phn.12944; source
    • cites [57] Acharya A, Ashrafian H, Cunningham D, Ruwende J, Darzi A, Judah G. Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: protocol for a randomised controlled trial. BMC Public Health. 2022; 22(1):1388. https://doi.org/10.1186/s12889-022-13781-x; source

  • May combine two claims.

    Findingcitation

    Promotora-led education programmes increased the knowledge and intention to be screened for CC and BC.

    “Promotora-led education programmes also increased the knowledge and intention to be screened for CC [51] and BC [45].”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [51] Musa J, Achenbach CJ, O'Dwyer LC, Evans CT, McHugh M, Hou L et al. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis. PloS One. 2017; 12(9):e0183924. https://doi.org/10.1371/journal.pone.0183924; source

      The Discussion’s “Cervical cancer education” section says educational interventions increased women’s knowledge of cervical cancer. Table 1 in the Results identifies a promotora-administered intervention and reports increased Pap-smear screening, but our copy does not report increased intention to be screened. The breast-cancer portion is attached to a different citation and is not assessed here. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [45] Hand T, Rosseau NA, Stiles CE, Sheih T, Ghandakly E, Oluwasanu M et al. The global role, impact, and limitations of Community Health Workers (CHWs) in breast cancer screening: a scoping review and recommendations to promote health equity for all. Glob Health Action. 2021; 14(1):1883336. https://doi.org/10.1080/16549716.2021.1883336; source

      The Results (Study characteristics) include five studies using promotoras under the review’s CHW category, and Results (Outcomes) reports increased breast-cancer knowledge in 21 CHW-intervention studies. The cited paper does not establish that promotora-led programmes increased intention to undergo breast-cancer screening; the cervical-cancer portion of the sentence has a separate citation. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    Strategies such as electronic medical records, prompts to remind patients, and a systematic process to generate lists of patients due for screening can increase screenings.

    “Strategies such as electronic medical records, prompts to remind patients, a systematic process to generate lists of patients due for screening, can increase screenings [35].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [35] Prusaczyk A, Zuk P, Guzek M, Bogdan M, Nitsch-Osuch A, Oberska J et al. An overview of factors influencing cancer screening uptake in primary healthcare institutions. Fam Med Prim Care Rev. 2022; 24(1):71-7. https://doi.org/10.5114/fmpcr.2022.113019; source

  • May combine two claims.

    Findingcitation

    Higher provider-to-patient ratio is associated with higher screening rate and lower provider burnout.

    “Higher provider-to-patient ratio is associated with higher a screening rate and lower provider burnout which in turn is associated with decreased quality of care [35].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [35] Prusaczyk A, Zuk P, Guzek M, Bogdan M, Nitsch-Osuch A, Oberska J et al. An overview of factors influencing cancer screening uptake in primary healthcare institutions. Fam Med Prim Care Rev. 2022; 24(1):71-7. https://doi.org/10.5114/fmpcr.2022.113019; source

  • May combine two claims.

    Findingcitation

    Based on a meta-analysis, monetary incentives have only modest effects on CRC and might not increase screening for populations with traditionally low screening rates.

    “Based on a meta-analysis, monetary incentives have only modest effects on CRC and might not increase screening for populations with traditionally low screening rates [60].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [60] Facciorusso A, Demb J, Mohan BP, Gupta S, Singh S. Addition of Financial Incentives to Mailed Outreach for Promoting Colorectal Cancer Screening: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021; 4(8):e2122581. https://doi.org/10.1001/jamanetworkopen.2021.22581; source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Reported results focus primarily on the WHO European Region.

    “Reported results focus primarily on the WHO European Region.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    55 English-language articles were identified.

    “55 English-language articles were identified.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Of the 55 articles, 19 were systematic reviews or meta-analyses.

    “Of these, 19 were systematic reviews or meta-analyses”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Key capability barriers to cancer screening included limited awareness, low health literacy, and forgetfulness.

    “Key capability barriers included limited awareness, low health literacy, and forgetfulness”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    For CRC, lack of awareness of CRC as a disease and lack of knowledge of the role of screening in CRC prevention can be barriers to screening.

    “For CRC for example, the lack of awareness of CRC as a disease and lack of knowledge of the role of screening in CRC prevention [9]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Honein-AbouHaidar GN, Kastner M, Vuong V, Perrier L, Daly C, Rabeneck L et al. Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev. 2016; 25:907-17. https://doi.org/10.1158/1055-9965.EPI-15-0990; source

  • May combine two claims.

    Findingnone given

    Drivers of cancer screening attendance included perceived benefits, high self-efficacy, supportive provider communication, and social encouragement.

    “Drivers included perceived benefits, high self-efficacy, supportive provider communication, and social encouragement.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Even in well-organised, free-of-charge programmes, women with lower SES and/or mental health problems are less likely to be screened.

    “A Dutch study indicates that even in well-organised, free-of-charge programmes, women with lower SES and/ or mental health problems are less likely to be screened [32].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Harder E, Juul KE, Jensen SM, Thomsen LT, Frederiksen K, Kjaer SK. Factors associated with non-participation in cervical cancer screening - A nationwide study of nearly half a million women in Denmark. Prev Med. 2018; 111:94-100. https://doi.org/10.1016/j.ypmed.2018.02.035; source

  • May combine two claims.

    Findingcitation

    Lack of transportation and difficulties in finding an escort for older adults are accessibility barriers.

    “Accessibility barriers include long distances and lack of access to healthcare services [10] as well as lack of transportation and difficulties in finding an escort for older adults [9].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Honein-AbouHaidar GN, Kastner M, Vuong V, Perrier L, Daly C, Rabeneck L et al. Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev. 2016; 25:907-17. https://doi.org/10.1158/1055-9965.EPI-15-0990; source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Providers' communication is important if their role is central in screening promotion actions.

    “Role of healthcare providers: Providers' communication is important if their role is central in screening promotion actions”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Educational multimedia interventions might be effective only in improving knowledge and attitudes about CC, but not in translating them into action.

    “According to a meta-analysis of effectiveness of CC screening interventions, educational multimedia interventions might be effective only in improving knowledge and attitudes about CC, but not in translating them into action [44].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Al-Oseely SA, Manaf RA, Ismail S. A Systematic Evaluation of Methods Used and the Effectiveness of Health Education Interventions to Improve Knowledge, Beliefs, and Practices of Cervical Cancer Screening. Malays J Med Health Sci 2021; 17(3):259-67. Available online: https://medic.upm.edu.my/upload/dokumen/2021062816042937_MJMHS_1042.pdf;

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    A wide range of interventions to increase screening was identified.

    “A wide range of interventions to increase screening was identified.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Interventions using face-to-face, remote, or mixed types of contact have all been shown to be effective.

    “Points of contact: Interventions using face-to-face, remote, or mixed types of contact have all been shown to be effective”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Findingnone given

    Tailoring materials for different ethnic/linguistic groups might be beneficial in increasing attendance and reducing disparities between groups.

    “Culture and language-sensitive material: If possible and relevant, tailoring materials for different ethnic/linguistic groups might be beneficial in increasing attendance and reducing disparities between groups”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    The involvement of trained community members is an important factor in community-based interventions.

    “Representation: The involvement of trained community members is an important factor in community-based interventions”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Personalised invitations and those signed by a physician work better than generic letters, especially for minority groups.

    “Personalisation: Personalised invitations and those signed by a physician work better than generic letters, especially for minority groups”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Fees and incentives have mixed results; there might not be any benefit of introducing small incentives.

    “Fees and incentives: Mixed results; there might not be any benefit of introducing small incentives”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Reminders and recall systems are effective in increasing screening uptake in all sociodemographic groups, especially when a stepwise increase of points and intensity of contact for non-attenders has been included.

    “Impact: Reminders and recall systems are effective in increasing screening uptake in all sociodemographic groups, especially when a stepwise increase of points and intensity of contact for non-attenders has been included”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In a systematic review of behavioural theory-based interventions to increase CC screening, involving women in discussions, using films and multiple audio-visual aids, and using self-learning materials were effective.

    “According to a systematic review of behavioural theory-based interventions to increase CC screening, involving women in discussions, using films and multiple audio-visual aids and using self-learning materials were effective [11].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] Dsouza JP, Van den Broucke S, Pattanshetty S, Dhoore W. The application of health behavior theories to promote cervical cancer screening uptake. Public Health Nurs. 2021; 38(6):1039-79. https://doi.org/10.1111/phn.12944; source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Targeting patients' social circles might be beneficial.

    “Multilevel approach: Targeting patients' social circles might be beneficial”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The influence of mass media on cancer screening is inconsistent and difficult to assess.

    “The influence of mass media is inconsistent and difficult to assess [9].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Honein-AbouHaidar GN, Kastner M, Vuong V, Perrier L, Daly C, Rabeneck L et al. Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev. 2016; 25:907-17. https://doi.org/10.1158/1055-9965.EPI-15-0990; source

  • May combine two claims.

    Findingnone given

    Small media may have a modest effect on screening uptake but this has not been demonstrated in all studies.

    “Small media: Use of e.g., educational booklets, videos, letters, may have a modest effect on screening uptake but this has not been demonstrated in all studies”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Findingnone given

    Screening services can be designated to nonphysician staff and separate clinics to enhance efficacy.

    “Reorganisation: Screening services can be designated to nonphysician staff (e.g., nurses) and separate clinics to enhance efficacy”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In RCTs, small media has had a modest impact on CRC screening uptake, although not demonstrated in all studies.

    “In RCTs, small media has had a modest impact on CRC screening uptake, although not demonstrated in all studies [9].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [9] Honein-AbouHaidar GN, Kastner M, Vuong V, Perrier L, Daly C, Rabeneck L et al. Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev. 2016; 25:907-17. https://doi.org/10.1158/1055-9965.EPI-15-0990; source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Some changes are costly and slow to implement.

    “Cost: Some changes are costly and slow to implement (e.g., redesigning service provision and settings).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    When an 'if-then' leaflet addressing common barriers and offering practical assistance was included with a CRC test kit, adherence in the experimental group was 1.2%-6.6% higher than in the control group, reaching 71.4% (vs. 67.9%) in the last six month wave.

    “When an 'if-then' leaflet addressing common barriers and offering practical assistance was included with a CRC test kit, adherence in the experimental group was 1.2%-6.6%higher than in the control group, reaching 71.4% (vs.67.9%) in the last six month wave [56].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [56] Neter E, Stein N, Barnett-Griness O, Rennert G, Hagoel L. From the bench to public health: population-level implementation intentions in colorectal cancer screening. Am J Prev Med. 2014; 46(3):273-80. https://doi.org/10.1016/j.amepre.2013.11.008; source

  • May combine two claims.

    Findingcitation

    Motivational interviewing, delivered face-to-face or by telephone, was effective in increasing BC and CC screening, but results for CRC were mixed.

    “A systematic review of effectiveness of motivational interviewing to promote cancer screening found that using motivational interviewing either face-to-face or on the telephone was effective in increasing BC and CC screening but with mixed results for CRC [49].”
    • Also stated in: § GP communication style. · plain
      “motivational interviewing has increased the uptake of BC and CC screening according to a systematic review [49].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [49] Chan DNS, So WKW. Effectiveness of motivational interviewing in enhancing cancer screening uptake amongst average-risk individuals: A systematic review. Int J Nurs Stud. 2021; 113:103786. https://doi.org/10.1016/j.ijnurstu.2020.103786; source

  • May combine two claims.

    Findingcitation

    In Armenia, invitation letters have increased CC screening, especially when there are follow-up reminders.

    “In Armenia, invitation letters have increased CC screening, especially when there are follow-up reminders [53].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [53] Antinyan A, Bertoni M, Corazzini L. Cervical cancer screening invitations in low and middle income countries: Evidence from Armenia. Soc Sci Med. 2021; 273:113739. https://doi.org/10.1016/j.socscimed.2021.113739; source

  • May combine two claims.

    Findingnone given

    Multiple interventions can boost screening rates, such as a GP endorsement letter and simplified testing procedure, or barrier counselling with guidance on booking a screening appointment.

    “Multiple interventions can boost screening rates, such as a GP endorsement letter and simplified testing procedure, or barrier counselling with guidance on booking a screening appointment”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The categorisations of results have been reviewed by members of the WHO Behavioural and Cultural Insights team.

    “The categorisations of results have been reviewed by members of the WHO Behavioural and Cultural Insights team.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The review was halted when information saturation was achieved and no new themes were identified by reviewing additional sources.

    “The review was halted when information saturation was achieved and no new themes were identified by reviewing additional sources.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The initial review and categorisations were done by a WHO consultant familiar with health behaviour change theories and interventions.

    “The initial review and categorisations were done by a WHO consultant familiar with health behaviour change theories and interventions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    Detailed information about anatomy and causes, symptoms, and risk factors together with highlighting protective factors of screening should enhance perceived susceptibility and severity of cancer as well as perceived benefits, and thus increase screening.

    “Content: Detailed information about anatomy and causes, symptoms, and risk factors together with highlighting protective factors of screening should enhance perceived susceptibility and severity of cancer as well as perceived benefits, and thus increase screening”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    Educational programmes can focus on enhancing skills and self-efficacy because increases in knowledge do not always lead to changes in screening behaviours.

    “Skill provision and self-efficacy: As increases in knowledge do not always lead to changes in screening behaviours, educational programmes can also focus on enhancing skills and self-efficacy”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    Publication bias may affect conclusions of effectiveness.

    “Publication bias may also affect conclusions of effectiveness.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    The main focus is studies from the WHO European region, but some findings from global reviews relate to health systems and geographical contexts outside the WHO European Region.

    “In terms of the geographical distribution, the main focus is studies from the WHO European region but some findings from global reviews relate to health systems and geographical contexts outside the WHO European Region.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Uptake of home-testing can be enhanced by advance notice and simplified testing procedures.

    “Uptake of home-testing can be enhanced by advance notice and simplified testing procedures”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    For CRC and CC, providing the test kit in the invitation letter and self-sampling at home can make screening easier.

    “For CRC and CC, providing the test kit in the invitation letter and self-sampling at home can make screening easier.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The rapid review approach may not have captured all relevant aspects.

    “Since this review utilised a rapid review approach (rather than a systematic review methodology) to gather evidence within a limited time, it may not have captured all relevant aspects.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Global meta-analyses suggest that many of the same factors are relevant across cultural settings.

    “However, global meta-analyses suggest that many of the same factors are relevant across cultural settings.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Inclusion and quality of the literature was assessed by one reviewer, which gives some risk of selection bias.

    “Inclusion and quality of the literature was assessed by one reviewer, which gives some risk of selection bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationnone given

    Some interventions might be very low-cost, easy-to-implement and effortless to engage with, whereas others might be more costly or require active engagement by the participants.

    “Some interventions might be very low-cost, easy-to-implement and effortless to engage with (e.g., a GP-signed invitation) whereas others might be more costly (e.g., organisational changes) or require active engagement by the participants (e.g., educational courses).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The selected search terms limited the study.

    “The selected search terms also limited the study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    This review does not consider the cost of interventions or the differences in how much engagement is required from the participants.

    “Finally, this review does not consider the cost of interventions or the differences in how much engagement is required from the participants.”
    Quote in the paperNot a substantial claim
61 of 61

  • The paper relies on this without support.

    Population-based cancer screening programmes can significantly reduce cervix, breast and colorectal cancer mortality and morbidity.

    “Population-based cancer screening programmes can significantly reduce cervix, breast and colorectal cancer mortality and morbidity.”

  • The paper relies on this without support.

    Many countries have set up screening programs for these cancers, but people do not always use them.

    “While many countries have set up screening programs for these cancers, people do not always use them.”

  • The paper relies on this without support.

    Cancer screening requires individuals to take actions such as ordering a test, self-sampling at home, or going to a screening facility.

    “Cancer screening requires individuals to take actions such as ordering a test, self-sampling at home, or going to a screening facility.”

  • The paper relies on this without support.

    Whether individuals take these actions can be influenced by structural barriers, social support systems, or cognitive factors (e.g., emotions or beliefs).

    “Whether individuals take these actions can be influenced by structural barriers, social support systems, or cognitive factors (e.g., emotions or beliefs).”

  • The paper relies on this without support.

    Intention is an important but not sufficient precondition for conscious behaviours.

    “Intention is usually an important but not sufficient precondition for conscious behaviours.”

  • The paper relies on this without support.

    Awareness is an important but not sufficient condition for cancer screening attendance.

    “Awareness is an important, but not sufficient condition for cancer screening attendance.”

  • The paper relies on this without support.

    Sometimes extra information is not beneficial.

    “Sometimes extra info is not beneficial.”

  • The paper relies on this without support.

    Not all cancers can be tested for at home; home testing applies only to cervical cancer (CC) and colorectal cancer (CRC).

    “Not all cancers can be tested for at home; applies only to CC and CRC.”

  • The paper relies on this without support.

    Some changes are costly and slow to implement (e.g., redesigning service provision and settings).

    “Cost: Some changes are costly and slow to implement (e.g., redesigning service provision and settings).”
9 of 9

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • COM-B's C is defined as both communication and capability

    Minor

    The Serbian text expands COM-B with "Communication" as its C component, while the English text identifies that component as "capability."

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Al-Oseely SA, Manaf RA, Ismail S. A Systematic Evaluation of Methods Used and the Effectiveness of Health Education Interventions to Improve Knowledge, Beliefs, and Practices of Cervical Cancer Screening. Malays J Med Health Sci 2021; 17(3):259-67. Available online: https://medic.upm.edu.my/upload/dokumen/2021062816042937_MJMHS_1042.pdf;
  2. Miller WR, Rollnick S. Motivational Interviewing: Helping People Change. 4th ed. New York (USA): Guilford Press; 2012. 338 p;

Authors
Palsola, M., Likki, T., Snijders, V., Corbex, M., Lasierra, L., & Curtis, B.
Affiliations
  • Finnish Institute for Health and Welfare (FI)
  • World Health Organization (CH)
  • World Health Organization Regional Office for Europe (DK)
ORCID
Venue
Glasnik javnog zdravlja
Publisher
Centre for Evaluation in Education and Science (CEON/CEES)
Published
2026
Volume
100
Issue
1
Pages
86-112
ISSN
  • 2812-7552 (ISSN-L)
  • 2812-8842
DOI
10.5937/serbjph2601086p
OpenAlex
W7134946926
Semantic Scholar
cf19c37cbcdd8066d075c7259ffaa3a863bedcd4
Cited by
0
References
60
FWCI
0.00
Type
journal article
Language
en
Open access
Locations
Glasnik javnog zdravlja (publishedVersion)
Funders
This research was funded by the WHO Regional Office for Europe
Topics
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
Keywords
cancer screening uptake, barriers to screening, COM-B model, cervical cancer screening, breast cancer screening, colorectal cancer screening, health literacy, sociocultural stigma, culturally tailored interventions, screening reminders, patient navigation, home testing, health behavior change

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-16.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-16.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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