scholarly journals Impact of a Targeted Free Mammography Screening Program for Underprivileged Women in Malaysia

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 28s-28s
Author(s):  
Viji Nair ◽  
Viji Dina Nazri ◽  
Angela Lau ◽  
Rozita Hashim ◽  
Clare Ratnasingham ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nongovernmental Organizations ◽  
Mammography Screening ◽  
Conflicts Of Interest ◽  
Screening Program ◽  
Disease Stage ◽  
Cancer Society ◽  
Insurance Carrier ◽  
Late Stages ◽  
Malaysian Women

Purpose Breast cancer remains the most prevalent cancer among Malaysians today. Almost two thirds of patients are diagnosed in the late stages of disease, stage III to IV, with poorer outcomes. In addition, evidence has also revealed that most of patients who present in these late stages are those from poorer socioeconomic backgrounds. Women from underprivileged backgrounds have been found to have poorer health-seeking behavior, especially in terms of screening for cancer. This is for a number of reasons, such as affordability, distance to health centers, and other socioeconomic factors, which have a large impact, as Malaysia only offers opportunistic screening for breast cancer and not for free. A specific program to provide free mammography screening targeted toward underprivileged Malaysian women was planned and implemented with the aim of improving access to screening and increasing the rate of screening among this specific group of women. Methods Funding for the program was obtained from successful negotiation with a large Malaysian life insurance carrier. To ensure geographic equity, screening services were strategically purchased from 15 hospitals that were spread out across Malaysia. We also built partnerships with various nongovernmental organizations working in the social arena servicing underprivileged groups to reach these groups specifically. The nongovernmental organizations co-organized awareness programs and screening days, together with the National Cancer Society Malaysia, with additional incentivization that included subsidizing transport to mammography centers. Results A total of 5,000 underprivileged women from different geographic localities and ethnicities were screened across Malaysia. Of these, 62% received a mammogram for the first time in their lives, whereas 21% received their first repeat mammogram in more than 3 years. Conclusion A targeted screening program that incorporated a multipronged approach strategy was successful at increasing access to breast cancer screening for underprivileged Malaysian women. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Murallitharan Munisamy Employment: National Cancer Society of Malaysia Stock or Other Ownership: MMPKV Sdn Bhd–operator of Malaysian Primary Care Clinics

scholarly journals Barriers to Mammography Screening in Nigeria: A Survey of Two Communities With Different Access to Screening Facilities

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 31s-31s
Author(s):  
Olalekan Olasehinde ◽  
Olusegun I. Alatise ◽  
Olukayode A. Arowolo ◽  
Victoria L. Mango ◽  
Olalere S. Olajide ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Local Government ◽  
Breast Cancer Screening ◽  
Mammography Screening ◽  
Conflicts Of Interest ◽  
Screening Program ◽  
Delayed Presentation ◽  
Screening Programs ◽  
Screening Practices

Purpose Breast cancer outcomes are poor in most low- and middle-income countries. This is a result, in part, of delayed presentation. Critical to improving this gloomy picture is the promotion of breast cancer screening programs; however, designing a formidable screening program requires obtaining necessary background data. This survey evaluates breast cancer screening practices and barriers in two Nigerian communities with different geographic access to screening facilities. Methods We administered a 35-item questionnaire to women age 40 years and older—1,169 participants (52.6%) in the Ife Central Local Government, where mammography services are offered, and 1,053 (47.4%) in the Iwo Local Government, where there are no mammography units. Information on breast cancer screening practices and barriers to mammography screening were compared between the two communities. Results Most women had heard of breast cancer (Ife, 94%; Iwo, 97%), but few have had any form of breast cancer screening recommended to them—37.7% of Ife respondents and 36.6% of Iwo respondents. Few women were aware of mammography (Ife, 11.8%; Iwo, 11.4%), whereas mammography uptake was 2.8% Ife respondents and 1.8% in Iwo respondents, despite the latter offering mammography services. Awareness and practice of mammography were not statistically different between the two communities ( P = .74 and P = .1 for Ife and Iwo, respectively). Lack of awareness was the most common reason cited for not undergoing mammography in both communities. Cost was also identified as a barrier, as only 20% of respondents could afford mammography. Despite being offered at little or no cost, uptake of clinical breast examination (CBE) was poor in both communities—27.4% in Iwo and 19.7% in Ife; however, the majority were willing to participate in a routine CBE-based breast cancer screening program. Conclusion Access without awareness and community mobilization does not guarantee use of breast cancer screening services. Given the above findings, a comprehensive breast health program that incorporates awareness creation, routine CBE-based screening, and selective mammography is currently underway in a selected Nigerian community. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the author

Mammographic Screening at Age 40 or 45? What Difference Does it Make? the Potential Impact of American Cancer Society Mammography Screening Guidelines

2017 ◽  
Vol 83 (8) ◽  
pp. 847-849
Author(s):  
Crystal E. Fancher ◽  
Anthony Scott ◽  
Ahkeel Allen ◽  
Paul Dale
Keyword(s):  
Breast Cancer ◽  
Mammography Screening ◽  
Disease Free Survival ◽  
Mammographic Screening ◽  
Screening Mammography ◽  
Cancer Society ◽  
Free Survival ◽  
Screening Guidelines ◽  
Potential Impact ◽  
Disease Free

This is a 10-year retrospective chart review evaluating the potential impact of the most recent American Cancer Society mammography screening guidelines which excludes female patients aged 40 to 44 years from routine annual screening mammography. Instead they recommend screening mammography starting at age 45 with the option to begin screening earlier if the patient desires. The institutional cancer registry was systematically searched to identify all women aged 40 to 44 years treated for breast cancer over a 10-year period. These women were separated into two cohorts: screening mammography detected cancer (SMDC) and nonscreening mammography detected cancer (NSMDC). Statistical analysis of the cohorts was performed for lymph node status (SLN), five-year disease-free survival, and five-year overall survival. Women with SMDC had a significantly lower incidence of SLN positive cancer than the NSMDC group, 9 of 63 (14.3%) versus 36 of 81 (44 %; P < 0.001). The five-year disease-free survival for both groups was 84 per cent for SMDC and 80 per cent for NSMDC; this was not statistically significant. The five-year overall survival was statistically significant at 94 per cent for the SMDC group and 80 per cent for the NSMDC group (P < 0.05). This review demonstrates the significance of mammographic screening for early detection and treatment of breast cancer. Mammographic screening in women aged 40 to 44 detected tumors with fewer nodal metastases, resulting in improved survival and reaffirming the need for annual mammographic screening in this age group.

A Culturally Targeted Intervention to Promote Breast Cancer Screening among Low-Income Women in East Baltimore, Maryland

2005 ◽  
Vol 12 (4_suppl) ◽  
pp. 34-41 ◽  
Author(s):  
Mary A. Garza ◽  
Jingyu Luan ◽  
Marcela Blinka ◽  
Reverend Iris Farabee-Lewis ◽  
Charlotte E. Neuhaus ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Low Income ◽  
Mammography Screening ◽  
Screening Program ◽  
Health Belief ◽  
Targeted Intervention ◽  
Screening Rate ◽  
American Women

In Maryland, outreach initiatives have been unsuccessful in engaging low-income African American women in mammography screening. This study aimed to identify factors influencing screening rates for low-income African American women. Based on the Health Belief Model, a modified time series design was used to implement a culturally targeted intervention to promote a no-cost mammography-screening program. Data were collected from women 40 years of age and older on their history of mammography use and their knowledge and beliefs about breast cancer. A 50% screening rate was achieved among 119 eligible participants. Significant predictors of screening behaviors were perceived barriers, lack of insurance, and limited knowledge. This culturally targeted intervention resulted in an unprecedented screening rate among low-income African American women in Baltimore, Maryland.

Breast cancer subtype and screening sensitivity in the Quebec Mammography Screening Program

2018 ◽  
Vol 26 (3) ◽  
pp. 154-161
Author(s):  
Linda Perron ◽  
Sue-Ling Chang ◽  
Jean-Marc Daigle ◽  
Nathalie Vandal ◽  
Isabelle Theberge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mammography Screening ◽  
Triple Negative ◽  
Screening Program ◽  
Luminal A ◽  
Her2 Positive ◽  
Cancer Subtypes ◽  
Luminal B ◽  
Mammography Screening Program ◽  
Screening Sensitivity

Objective In mammography screening, interval cancers present a problem. The metric ‘screening sensitivity’ monitors both how well a programme detects cancers and avoids interval cancers. To our knowledge, the effect of breast cancer surrogate molecular subtypes on screening sensitivity has never been evaluated. We aimed to measure the 2-year screening sensitivity according to breast cancer subtypes. Methods We studied 734 women with an invasive breast cancer diagnosed between 2003 and 2007 after participating in one regional division of Quebec’s Mammography Screening Program. They represented 83% of all participating women with an invasive BC diagnosis in that region for that period. Tumours were categorized into ‘luminal A-like’, ‘luminal B-like’, ‘triple-negative’ and ‘HER2-positive’ subtypes. We used logistic regression and marginal standardization to estimate screening sensitivity, sensitivity ratios (SR) and sensitivity differences. We also assessed the mediating effect of grade. Results Adjusted 2-year screening sensitivity was 75.4% in luminal A-like, 66.1% in luminal B-like, 52.9% in triple-negative and 45.3% in HER2-positive, translating into sensitivity ratios of 0.88 (95% confidence interval [CI] = 0.78–0.98) for luminal B-like, 0.70 (CI = 0.56–0.88) for triple-negative and 0.60 (CI = 0.39–0.93) for HER2-positive, when compared with luminal A-like. Grade entirely mediated the subtype-sensitivity association for triple negative and mediated it partly for HER2-positive. Screening round (prevalent vs. incident) did not modify results. Conclusion There was substantial variation in screening sensitivity according to breast cancer subtypes. Aggressive phenotypes showed the lowest sensitivity, an effect that was mediated by grade. Tailoring screening according to women’s subtype risk factors might eventually lead to more efficient programs.

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