Table 1.
Synthesized effect size of associated factors for adherence to cervical cancer screening
| No. of studies | Odds ratio (95%CI) | Heterogeneity | ||
|---|---|---|---|---|
| I2, % | Q test-P value | |||
| Demographic characteristics | ||||
| Associated factor 1: Marital status | ||||
| Married vs Not married | 15 | 1.34 (1.23–1.46) | 98.3 | < 0.001 |
| Married vs Single | 12 | 1.62 (1.36–1.93) | 92.8 | < 0.001 |
| Partnered vs Not partnered | 9 | 1.41 (1.13–1.75) | 78.6 | < 0.001 |
| Currently married vs Never married | 3 | 3.76 (2.61–5.44) | 0.0 | 0.548 |
| Previously married vs Never married | 3 | 2.63 (1.66–4.15) | 0.0 | 0.403 |
| Married vs Divorced/Widowed/Separated | 5 | 1.14 (1.02–1.28) | 98.7 | < 0.001 |
| Divorced/Widowed/Separated vs Single | 5 | 1.51 (1.22–1.87) | 91.5 | < 0.001 |
| Social determinants of health | ||||
| Associated factor 2: Education level | ||||
| High school vs less than high school | 53 | 1.31 (1.24–1.38) | 93.8 | < 0.001 |
| Higher than high school vs less than high school | 47 | 1.44 (1.35–1.53) | 95.1 | < 0.001 |
| Associated factor 3a: Healthcare-Insurance | 8 | 1.64 (1.43–1.88) | 3.9 | 0.400 |
| Associated factor 3b: Healthcare-Healthcare coverage | 4 | 2.07 (1.59–2.69) | 83.5 | < 0.001 |
| Associated factor 4: Employment status | 20 | 1.05 (0.97–1.13) | 95.3 | < 0.001 |
| Lifestyle factors | ||||
| Associated factor 5: Body-mass index | ||||
| Obesity: BMI ≥30.0 kg/m2 vs Non-obesity | 9 | 0.78 (0.72–0.83) | 0.0 | 0.920 |
| Underweight: BMI < 18.5 kg/m2 vs Normal: BMI 18.5–24.9 kg/m2 | 8 | 0.76 (0.58–1.00) | 73.9 | < 0.001 |
| Overweight: BMI 25.0–30.0 kg/m2 vs Normal: BMI 18.5–24.9 kg/m2 | 12 | 0.98 (0.90–1.06) | 52.6 | 0.017 |
| Obesity: BMI ≥30.0 kg/m2 vs Normal: BMI 18.5–24.9 kg/m2 | 12 | 0.85 (0.74–0.97) | 84.1 | < 0.001 |
| Associated factor 6: Smoking | ||||
| Smoker vs Non-smoker | 14 | 0.87 (0.75–1.01) | 84.6 | < 0.001 |
| Current vs Former/Never | 5 | 0.64 (0.54–0.76) | 32.8 | 0.203 |
| Current vs Never | 11 | 0.89 (0.78–1.02) | 90.4 | < 0.001 |
| Former vs Never | 7 | 1.20 (1.07–1.34) | 84.9 | < 0.001 |
| Associated factor 7: Alcohol drinking | 12 | 1.02 (0.86–1.21) | 80.5 | < 0.001 |
| Associated factor 8: Physical activity | 11 | 1.19 (1.05–1.36) | 88.8 | < 0.001 |
| Personal history | ||||
| Associated factor 9: Parity | 11 | 1.07 (1.01–1.12) | 92.5 | < 0.001 |
| Associated factor 10: Mental illness | 3 | 1.07 (0.92–1.25) | 90.0 | < 0.001 |
| Associated factor 11: Chronic disease | 9 | 1.17 (1.04–1.32) | 80.2 | < 0.001 |
Abbreviations: BMI body-mass index, CI confidence interval. The definitions of some associated factors varied slightly across studies. Odds ratios for binary variable associated factors indicated better adherence to cervical cancer screening compared with those without the associated factor, except for married (vs not married), married (vs single), partnered (vs not partnered), currently married (vs never married), previously married (vs never married), married (vs divorced/widowed/separated), divorced/widowed/separated (vs single), high school (vs less than high school), higher than high school (vs less than high school), underweight/BMI < 18.5 kg/m2 (vs normal/BMI 18.5–24.9 kg/m2), overweight/BMI 25.0–30.0 kg/m2 (vs normal/BMI 18.5–24.9 kg/m2), obesity/BMI ≥ 30.0 kg/m2 (vs normal/BMI 18.5–24.9 kg/m2), and smoker (vs non-smoker), current smoker (vs former/never), current smoker (vs never), former smoker (vs never)