Caring for the caregivers: breast and cervical cancer screening among informal caregivers of cancer patients - a scoping review.

backgroundBreast and cervical cancer remain major contributors to the global morbidity and mortality among women, with early detection through screening being the key to prevention. Multiple factors influence the screening uptake, and informal caregiving for a family member with cancer may further influence their engagement in cancer screening. Evidence on breast and cervical cancer screening among women who are informal cancer caregivers remains fragmented. Hence, this scoping review aimed to identify the factors influencing and interventions that enhanced breast and cervical cancer screening, among women who are informal caregivers of cancer patients.

methodsFollowing the JBI methodology for scoping review, a comprehensive search was conducted in PubMed, CINAHL, Web of Science, Embase, Scopus, and grey literature sources. A predefined set of inclusion and exclusion criteria was used to select the studies from across the globe. Data was extracted and narratively synthesised, with supporting tables and diagrams.

resultsNine studies from Asia, Africa, Europe and North America were included. Though some studies reported that caregiving status was linked to greater uptake of breast and cervical cancer screening, lack of knowledge and fear of cancer diagnosis hindered screening for both cancers. Breast cancer screening was higher among older, educated caregivers and female relatives (e.g., sisters), and was facilitated by positive outcome expectations, goal setting, perceived self-efficacy, and social support. Fear of cancer recurrence presented a nuanced association; moderate fear enhanced age-appropriate breast cancer screening, while higher fear led to excessive screening. Cervical cancer screening was hindered by fear of pain, social consequences, cultural beliefs, stigma, privacy concerns, limited access to screening centres, and husbands' hesitancy. A telephonic counselling by a trained nurse enhanced breast cancer screening; no interventions were found that enhanced cervical cancer screening in informal cancer caregivers, indicating a significant research gap.

conclusionMost identified factors mirrored those reported among the general female population, with limited exploration of caregiving-specific contextual factors, and caregiver-specific interventions for breast and cervical cancer screening remain scarce. Integrating physician-initiated education and counselling, and opportunistic screening during the routine clinical encounters for the cancer patient presents a promising approach to enhance breast and cervical cancer screening among informal cancer caregivers.