Investigating barriers and facilitators to engagement with the National Breast Screening Programme among women in Malta: A systematic review

Objective: This systematic review aimed to identify the barriers and facilitators affecting engagement with Malta’s National Breast Screening Programme (NBSP) among women aged 50-69, focusing on studies published over the past decade.

Methods: A comprehensive search of PsycINFO, PsychArticles, MEDLINE, and Google Scholar was conducted in June 2024, resulting in 48 records. Five full-text papers met the inclusion criteria, comprising English-language studies with quantitative, qualitative or mixed-method designs that examined breast screening engagement in Malta. Independent risk of bias and quality assessments were conducted using the Joanna Briggs Institute checklist for cross-sectional studies.

Results: The review analysed data from 911 women, with a mean age range of 54.6-58.0 years. Barriers and facilitators to NBSP participation were categorised into three levels: psychological (knowledge gaps, fear and anxiety, health beliefs and illness perceptions), social (educational level, income and marital status), and healthcare-related (patient satisfaction and accessibility).

Conclusions: The findings indicate that targeted educational initiatives, improved accessibility, and enhanced patient support could significantly boost screening uptake, leading to earlier breast cancer detection, reduced mortality rates, and better health outcomes for women in Malta.
Conclusion: These insights are not only valuable for refining breast screening programmes across Europe, but can also inform similar initiatives globally, particularly in countries with comparable barriers and healthcare challenges. Adopting these strategies in diverse contexts may help improve women’s health outcomes worldwide.