Breast cancer examination uptake and its associated factors among women in East African countries: A systematic review and meta-analysis

Breast cancer is a global public health issue and the leading cause of cancer-related morbidity and mortality among women. Its burden is rising rapidly in low- and middle-income countries. In resource-limited settings, clinical breast examination (CBE) offers a feasible and cost-effective screening method for early detection. Despite its importance, the regional evidence on CBE uptake and its determinants in East Africa remains limited. Therefore, this study aimed to estimate the pooled uptake of CBE and its associated factors among women in the region. This study adhered to the PRISMA 2020 guidelines and included all observational studies published between January 1, 2015, and April 30, 2025. Databases such as PubMed, Scopus, Research4Life, and Google Scholar were searched. Publication bias was assessed using the funnel plot and Egger’s regression analysis. Furthermore, subgroup and sensitivity analyses were performed. A total of 51, 100 participants from fifteen studies were included in this analysis. The pooled uptake of CBE in East African countries was 15% (95% CI: 12%, 18%). Women aged 35–49 years (AOR = 2.84; 95% CI: 1.57, 5.13), higher educational attainment (AOR = 2.31; 95% CI: 1.48, 3.60), and having awareness of breast cancer screening methods (AOR = 2.05; 95% CI: 1.23, 3.28) were more likely to uptake CBE services. However, rural residence was associated with lower odds (AOR = 0.82; 95% CI: 0.68–0.99) of CBE. Clinical breast examination uptake was low women in East Africa is low. Higher CBE uptake was associated with being aged 35–49, higher education, and awareness of screening methods; while rural residence was associated with lower uptake. National policy makers and stakeholders should consider prioritize raising awareness and embedding screening into primary healthcare, particularly for rural, younger, and lower educational level women to enhance CBE uptake.