Financial incentives for women's cervical, breast and colorectal cancer screening adherence: systematic review and meta-analysis

Objective To evaluate the effectiveness of financial incentives on women's participation in cervical, breast, and colorectal cancer screening. Methods We conducted a systematic review and meta-analysis of quantitative studies evaluating financial incentives to increase women's participation in cancer screening. MEDLINE, CINAHL, and the Cochrane Library were searched from December 2024 to June 2025. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Certainty of evidence was assessed using GRADE. The review protocol was registered in PROSPERO (CRD42025640357). Results Eleven studies were included. Financial incentives were associated with increased screening participation - RR 1.42 (95% CI 1.05, 1.92); I2 = 98.30%. Effect estimates varied across follow-up time windows, with larger point estimates observed when screening uptake was assessed within ≤1 month of incentive delivery – RR 2.69 (95% CI 1.05, 6.89) - and effects remained detectable at approximately one year - RR 1.57 (95% CI 1.00, 2.46). Incentives in the range of approximately USD 10–25 were commonly used across trials and were often associated with positive effects. Conclusions Financial incentives may improve women's screening participation. Further studies are needed to evaluate the effectiveness of different incentive magnitudes and delivery strategies, alone or in combination with other interventions.