Mobile cancer preventive and early detection clinic in Uganda: Working with local communities as partners towards bridging the cancer health disparity

Background As high-income countries experience over-diagnosis of cancer diseases, the low-income countries are characterized by under-diagnosis or no diagnosis of even the most prevalent cancers. The Comprehensive Community Cancer Program (CCCP) is a community health unit of the Uganda Cancer Institute (UCI) that coordinates and implements primary prevention of cancer and early detection in Uganda. CCCP provides cancer information and screening services at UCI, in rural communities through mobile outreaches, mass media cancer awareness and training health workers on cancer prevention and early detection. We explored the feasibility and benefit of conducting outreaches in partnership with local communities.Methods We analyzed the quarterly UCI-CCCP cancer health education and screening output report data form July 2016 to June 2019 to compare UCI-hospital-based and community outreach cancer awareness and screening services.Results From July 2016 to June 2019, we worked with 107 local partners and conducted 151 outreaches. Out of the total number of people who attended cancer health education sessions, 77.9% were reached through outreaches. Ninety-two (95%) cancer awareness TVs and radio talk-shows conducted were sponsored by local partners. Out of the total people screened; 63.0% cervical, 64.4% breast and 38.7% prostate screening clients were screened through outreaches. The screen-positive rates were higher in hospital-based screening except for Prostate screening; cervical, 8.8%, breast, 8.4% prostate, 7.1 than in outreaches; cervical, 3.2%, breast, 2.2%, prostate, 8.2%). Out of the screened positive clients who were eligible for pre-cancer treatment like cryotherapy for treatment of pre-cervical cancer lesions, thousands-folds monetary value and productive life saved relative to the market cost of cancer treatment and survival rate in Uganda. When the total number of clients screened for cervical, breast and prostate cancer are subjected to the incremental cost of specific screening, a greater portion (98.7%) of the outreach cost was absorbed through community partnership.Conclusions Outreaching and working in collaboration with communities as partners help in cost-sharing and leverage for scarce resources to promote primary prevention and early detection of cancer. This contributes to bridging cancer health disparity in the population.