Evidence map›Paper›PMID 26646754›Full record

SynthesisAnnals of oncology : official journal of the European Society for Medical Oncology2016

Factors affecting uptake and adherence to breast cancer chemoprevention: a systematic review and meta-analysis.

S G Smith, I Sestak, A Forster, A Partridge, L Side, M S Wolf, R Horne, J Wardle, J Cuzick

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of oncology : official journal of the European Society for Medical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05133674 (Therapeutic Dose Monitoring), which is not on this map. Cited by 130 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
130citing papers in PubMed, 7 pooled it
21.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05133674 phase2unknown statusnot on this mapstarted 2022, after this paper: background citation

Therapeutic Dose Monitoring (TDM) of Tamoxifen and Its Active Metabolites in Combination With Patient-reported Symptom Scores Among Patients With Breast Cancer Receiving Adjuvant Tamoxifen Treatment

TypeinterventionalSponsorKarolinska University HospitalRan2022 to 2023Enrolled40ConditionsBreast Cancer, Breast Carcinoma, Breast Tumors, Cancer of BreastArmsTamoxifen 20 mg
3 · Its place in the literature

Who cites it

130 citing papers in PubMed, 7 syntheses or guidelines pooled it, 254 citations in OpenAlex.

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  7. Factors affecting uptake and adherence to breast cancer chemoprevention: a systematic review and meta-analysis.Annals of oncology : official journal of the European Society for Medical Oncology · 2016
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  15. Low-Dose Tamoxifen for Mammographic Density Reduction: A Randomized Controlled Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021
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  19. Participant-Reported Symptoms and Their Effect on Long-Term Adherence in the International Breast Cancer Intervention Study I (IBIS I).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2017
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70 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

S G SmithWolfson Institute of Preventive Medicine, Queen Mary University of London, London Health Behaviour Research Centre, University College London, London, UK sam.smith@qmul.ac.uk.
I SestakWolfson Institute of Preventive Medicine, Queen Mary University of London, London.
A ForsterHealth Behaviour Research Centre, University College London, London, UK.
A PartridgeDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA.
L SideInstitute for Women's Health, University College London, London, UK.
M S WolfDivision of General Internal Medicine, Northwestern University, Chicago, USA.
R HorneCentre for Behavioural Medicine, University College London, London, UK.
J WardleHealth Behaviour Research Centre, University College London, London, UK.
J CuzickWolfson Institute of Preventive Medicine, Queen Mary University of London, London.
University College London · GBQueen Mary University of London · GBDana-Farber Cancer Institute · USNorthwestern University · US

Funding

Cancer Research UK 16891Cancer Research UK 17429Cancer Research UK 17965Cancer Research UK A17965Cancer Research UK C42785/A17965Cancer Research UK C49896/A17429
6 · The paper itself

Abstract

backgroundPreventive therapy is a risk reduction option for women who have an increased risk of breast cancer. The effectiveness of preventive therapy to reduce breast cancer incidence depends on adequate levels of uptake and adherence to therapy. We aimed to systematically review articles reporting uptake and adherence to therapeutic agents to prevent breast cancer among women at increased risk, and identify the psychological, clinical and demographic factors affecting these outcomes.

designSearches were carried out in PubMed, CINAHL, EMBASE and PsychInfo, yielding 3851 unique articles. Title, abstract and full text screening left 53 articles, and a further 4 studies were identified from reference lists, giving a total of 57. This review was prospectively registered with PROSPERO (CRD42014014957).

resultsTwenty-four articles reporting 26 studies of uptake in 21 423 women were included in a meta-analysis. The pooled uptake estimate was 16.3% [95% confidence interval (CI) 13.6-19.0], with high heterogeneity (I(2) = 98.9%, P < 0.001). Uptake was unaffected by study location or agent, but was significantly higher in trials [25.2% (95% CI 18.3-32.2)] than in non-trial settings [8.7% (95% CI 6.8-10.9)] (P < 0.001). Factors associated with higher uptake included having an abnormal biopsy, a physician recommendation, higher objective risk, fewer side-effect or trial concerns, and older age. Adherence (day-to-day use or persistence) over the first year was adequate. However, only one study reported a persistence of ≥ 80% by 5 years. Factors associated with lower adherence included allocation to tamoxifen (versus placebo or raloxifene), depression, smoking and older age. Risk of breast cancer was discussed in all qualitative studies.

conclusionUptake of therapeutic agents for the prevention of breast cancer is low, and long-term persistence is often insufficient for women to experience the full preventive effect. Uptake is higher in trials, suggesting further work should focus on implementing preventive therapy within routine care.

Indexed as

Breast NeoplasmsChemopreventionFemaleHumansRaloxifene HydrochlorideTamoxifenRaloxifene HydrochlorideTamoxifenadherencechemopreventiondecision-makingmedicationpreventive therapyuptake

Identifiers

PMID26646754
PMCPMC4803450
OpenAlexW2195518879

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.