SynthesisBMC health services research2020
Adherence to breast cancer guidelines is associated with better survival outcomes: a systematic review and meta-analysis of observational studies in EU countries.
Synthesis in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 6 of them syntheses that pooled it.
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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.
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Who cites it
34 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Barriers and facilitators of adherence to clinical practice guidelines in Germany-A systematic review.Journal of evaluation in clinical practice · 2025Pooled it
- Quality indicators for systemic anticancer therapy services: a systematic review of metrics used to compare quality across healthcare facilities.European journal of cancer (Oxford, England : 1990) · 2023Pooled it
- Identifying the effective behaviour change techniques in nutrition and physical activity interventions for the treatment of overweight/obesity in post-treatment breast cancer survivors: a systematic review.Cancer causes & control : CCC · 2023Pooled it
- Characteristics and impact of interventions to support healthcare providers' compliance with guideline recommendations for breast cancer: a systematic literature review.Implementation science : IS · 2023Pooled it
- The effectiveness of clinical guideline implementation strategies in oncology-a systematic review.BMC health services research · 2023Pooled it
- Effects of evidence-based clinical practice guidelines for breast cancer in health care quality improvements. A second systematic review.F1000Research · 2022Pooled it
- Breast cancer in previously thyroidectomized patients: which thyroid disorders are a risk factor?Future science OA · 2021Trial
- The Level of Knowledge, Attitude, Practice, and Adherence of Obstetricians and Gynecologists Towards the Triple Elimination Program (HIV, Syphilis, Hepatitis B) in Maternal Services at Government and Private Hospitals in Jakarta.International journal of environmental research and public health · 2026Article
- Factors influencing acupuncture regimen completion by breast cancer patients: real-world data from an NCI-designated comprehensive cancer center.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Understanding health care practitioners' criteria regarding the decision to treat men with premature ejaculation.Sexual medicine · 2026Article
- Mortality following cancer diagnosis among people with non-affective psychoses: mediation by stage at diagnosis and time to treatment initiation.Social psychiatry and psychiatric epidemiology · 2026Article
- Prescribing variation across Europe: Insights into prescribing practices and educational needs.British journal of clinical pharmacology · 2026Article
- Public health determinants of screening accessibility, diagnostic and treatment timeliness, care adherence, and survival outcomes in breast cancer patients.Frontiers in public health · 2026Article
- Improving survival outcomes of people with ABC: a global expert review and call-to-action for 2025-2035 (Goal 1).Breast (Edinburgh, Scotland) · 2025Review
- Socioeconomic inequalities in adherence to clinical practice guidelines and breast cancer survival: a multicentre population-based study in Spain.BMJ quality & safety · 2025Article
- Factors Influencing the Relationship Between Sugar Consumption and Depression Among Women Under Breast Cancer Treatment.Behavioral sciences (Basel, Switzerland) · 2025Article
- Clinical Practice Guidelines Adherence and the Impact on Health Outcomes in Oncology: A Systematic Review and Meta-Analysis.Clinical and public health guidelines · 2025Article
- Assessing TDApp: An AI-based clinical decision support system for ADHD treatment recommendations.Frontiers in psychiatry · 2025Article
- Review
- What matters most to older adults in treatment decision making: A discrete choice experiment.PloS one · 2025Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundBreast cancer (BC) clinical guidelines offer evidence-based recommendations to improve quality of healthcare for patients with or at risk of BC. Suboptimal adherence to recommendations has the potential to negatively affect population health. However, no study has systematically reviewed the impact of BC guideline adherence -as prognosis factor- on BC healthcare processes and health outcomes. The objectives are to analyse the impact of guideline adherence on health outcomes and on healthcare costs.
methodsWe searched systematic reviews and primary studies in MEDLINE and Embase, conducted in European Union (EU) countries (inception to May 2019). Eligibility assessment, data extraction, and risk of bias assessment were conducted by one author and crosschecked by a second. We used random-effects meta-analyses to examine the impact of guideline adherence on overall survival and disease-free survival, and assessed certainty of evidence using GRADE.
resultsWe included 21 primary studies. Most were published during the last decade (90%), followed a retrospective cohort design (86%), focused on treatment guideline adherence (95%), and were at low (80%) or moderate (20%) risk of bias. Nineteen studies (95%) examined the impact of guideline adherence on health outcomes, while two (10%) on healthcare cost. Adherence to guidelines was associated with increased overall survival (HR = 0.67, 95%CI 0.59-0.76) and disease-free survival (HR = 0.35, 95%CI 0.15-0.82), representing 138 more survivors (96 more to 178 more) and 336 patients free of recurrence (73 more to 491 more) for every 1000 women receiving adherent CG treatment compared to those receiving non-adherent treatment at 5 years follow-up (moderate certainty). Adherence to treatment guidelines was associated with higher costs, but adherence to follow-up guidelines was associated with lower costs (low certainty).
conclusionsOur review of EU studies suggests that there is moderate certainty that adherence to BC guidelines is associated with an improved survival. BC guidelines should be rigorously implemented in the clinical setting.
trial registrationPROSPERO ( CRD42018092884 ).
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