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Background: Breast cancer is the most common cancer among women in the State of Qatar, and the incidence rate is rising. Previous findings indicate women in Qatar are often diagnosed with breast cancer at advanced stages and their participation rates in screening activities are low. Purpose: To investigate within the State of Qatar Arabic women’s knowledge regarding breast cancer and breast cancer screening (BCS) methods and their participation rates in BCS. This paper reports on the results of a cross-sectional survey. Methods: A quantitative, cross-sectional interview survey was conducted with 1,063 Arabic women (Qatari citizens and non-Qatari Arabic-speaking residents), 35 years of age or older, from March 2011 to July 2011. Results: Of the 1,063 women interviewed (87.5% response rate), 90.7% were aware of breast cancer; 7.6% were assessed with having basic knowledge of BCS, 28.9% were aware of breast self-examination (BSE), 41.8% were aware of clinical breast exams (CBE), and 26.9% were aware of mammograms. Of the women interviewed, 13.8% performed BSE monthly, 31.3% had a CBE once a year or once every two years, and 26.9% of women 40 years of age or older had a mammogram once a year or once every two years. Participation rates in BCS activities were significantly related to awareness and knowledge of BCS, education levels, and receiving information about breast cancer, self-examination or mammography from any of a variety of sources, particularly physicians. Conclusions: Study results demonstrate that despite the existent breast cancer screening recommendations, less than one-third of Arabic women living in Qatar participate in BCS activities. Public health campaigns encouraging more proactive roles for health care professionals regarding awareness and knowledge of breast cancer, BCS, and the benefits of early detection of breast cancer will help increase screening rates and reduce mortality rates among Arabic women living in the State of Qatar.

Breast cancer is a public health threat in the State of Qatar. It is the most common cancer and the incidence rate is increasing. It has been found that women often present with breast cancer at advanced stages in Qatar. Early detection of breast cancer is an important prognostic factor and breast cancer screening has been found successful in decreasing mortality rates. The percentage of women in Qatar engaging in screening activities is alarmingly low. A study has been designed to examine barriers and facilitators that are potentially influencing women in participating in breast cancer screening activities. Understanding these barriers and facilitators is essential in order to create a culturally appropriate and effective intervention that can encourage women in Qatar to participate in screening activities. In this paper the background to the study is presented which highlights the magnitude of the breast cancer problem in Qatar and offers the rationale and information for this potentially groundbreaking study.

Background Qatar has one of the highest age-adjusted breast cancer incidences in the Arab world. Although this is much lower than the incidence in the West. Breast cancer incidence in Qatar was 45 per 100,000 in 2003-2007.These higher incidence rates in Qatar are mainly due to the growing population. The prevalent age group, for Qatari and non-Qatari patients, was 40-50 years old. This suggests that the age-specific incidence of breast cancer in Qatari women is unlike the pattern usually seen in Western nations where median age at diagnosis is 61 years, moreover the diagnosis is often at advanced stages of breast cancer. These factors led to establishment the first hospital based (BCSP) in Qatar. It uses a distributed model of mammography service. The program launched 2008, accepts eligible asymptomatic women at ages 40 - 69 years. Methods A retrospective study was done during the period from April 2008 –December 2013. Our aim is to describe our experience of (BCSP) in Qatar and to monitor performance indicators. Our (BCSP) includes an office call and recall as well as triple assessment. We also discuss positive cases in multi-disciplinary meeting. Results Total number of screened women was 4264 with an increasing participation, year by year. Out of these, Qatari patient’s accounts for 1145, and non Qatari for 3119. The age group of cases was (43-51). Total breast biopsies were 82, of which 45 were positive of breast carcinomas, (37) invasive ductal carcinoma, (8) noninvasive ductal carcinoma. The Invasive cancer detection rate was 8.2 %. The positive predictive value (PPV) was 46%. Sensitivity value has improved from 51% in 2008 to 70% in 2012 as well as specificity value that has increased from 77% in 2008 to 83% in 2012. Conclusion Public acceptance of (BCSP) in Qatar gradually increased and detection rates are higher than western countries. We’re detecting biologically aggressive tumors at younger age groups. We’ve a unique population and we need to utilize our data and evidence based medicine to guide policy makers and women to make the correct decision towards (BCSP). Citation Format: Salha Bujassoum, Reena Alassam, Hekmat Bugrein, Mufid Elmistiri. Qatar experience of Standard risk breast cancer screening program (BCSP) [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-02-05.

18 Background: Qatar has one of the highest age-adjusted breast cancer incidences in the Arab world. Although this is much lower than the incidence in the West. Breast-cancer incidence in Qatar was 45 per 100,000 in 2003 to 2007.These higher incidence rates in Qatar are mainly due to the growing population. The prevalent age group, for Qatari and non-Qatari patients, was age 40 to 50. This suggests that the age-specific incidence of breast cancer in Qatari women is unlike the pattern usually seen in Western nations where median age at diagnosis is 61 years, moreover the diagnosis is often at advanced stages of breast cancer. These factors led to establishment the first hospital based (BCSP) in Qatar. It uses a distributed model of mammography service. The program launched 2008, accepts eligible asymptomatic women at ages 40 to 69. Methods: Retrospective study was done during the period from April 2008 to December 2013. Our aim is to describe our experience of (BCSP) in Qatar and to monitor performance indicators. Our (BCSP) includes an office call and recall as well as triple assessment. We also discuss positive cases in multidisciplinary meeting. Results: Total number of screened women was 4,264 with an increasing participation, year by year. Out of these, Qatari patient’s accounts for 1,145, and non Qatari for 3,119. The age group of cases was (43 to 51). Total breast biopsies were 82, of which 45 were positive of breast carcinomas, (37) invasive ductal carcinoma, (8) noninvasive ductal carcinoma. The invasive cancer detection rate was 8.2 %. The positive predictive value (PPV) was 46%. Sensitivity value has improved from 51% in 2008 to 70% in 2012 as well as specificity value that has increased from 77% in 2008 to 83% in 2012. Conclusions: Public acceptance of (BCSP) in Qatar gradually increased and detection rates are higher than western countries. We’re detecting biologically aggressive tumors at younger age groups. We’ve a unique population and we need to utilize our data and evidence based medicine to guide policy makers and women to make the correct decision towards (BCSP).

Background: Breast cancer is the most common cancer among women in Qatar, incidence rate is rising and it is often diagnosed at advanced stages. Early detection of breast cancer through regular screening activities has been found to decrease morbidity and mortality rates. Although research on breast cancer screening in the Middle East is scarce, low levels of knowledge and poor participation rates have been found to act as barriers towards breast cancer screening activities such as breast self-examination, clinical breast examination and mammography. Various other barriers have been described in the literature. Identification of these potential barriers and facilitators is urgently needed in order to develop culturally appropriate interventions aiming to improve awareness and breast cancer screening participation rates. Objectives: A three-phase research program for which the goals are to (1) Understand breast health issues in Qatar; (2) Identify and implement strategies that assist Arabic women's participation in breast cancer screening activities (3) Evaluate, facilitate and sustain these strategies. Methods: In Phase 1 two studies are conducted. Study 1: this quantitative study examines data from a convenience sample of 1063 Arabic women in Qatar on a cross sectional community based survey. Face to face interviews are used to investigate knowledge, attitudes, practices, barriers and facilitators regarding breast cancer screening activities. Study 2: Using an ethnographic qualitative methodology, this study will capture the complexity and diversity of reasons of health behaviour choices on a purposive sample of 50 women, 50 men and 30 health care providers. Results: Preliminary results from study 1 will be presented. These will include: participation rates of breast cancer screening activities of Arabic women in Qatar such as breast self-examination, clinical breast examination and mammography; levels of knowledge of breast cancer and its screening; identified barriers and facilitators to breast cancer screening as experienced by these women. Conclusion: Combined results will enable development of culturally appropriate intervention strategies to raise awareness and participation rate in breast cancer screening among Arabic women living in Qatar and the Gulf region.

Breast cancer is frequently diagnosed in Arab women living in Qatar. Al Amal Hospital in Doha reported that 20% of cancer cases receiving treatment in 2007 involved the treatment of breast cancer among women. Early detection and treatment can reduce breast cancer morbidity and mortality rates significantly. However, Arab women are often diagnosed at advanced stages of breast cancer. Funded by the Qatar National Research Fund - National Priorities Research Program, we are undertaking a three-phase research program for which the goals are; (1) to understand the breast health experience of Arab women in Qatar, (2) identify and implement strategies that assist women to participate in breast cancer screening activities, and (3) evaluate, facilitate, and sustain the participation of Arab women in breast cancer screening. In phase I of the research program we will conduct two studies. Study 1: This quantitative cross-sectional survey will investigate the participation rate of Arab women in breast cancer screening, their knowledge about breast cancer, barriers and facilitators to participation. Using a structured questionnaire, we will conduct face-to-face interviews with Arab women aged 35 and over in three different cities in Qatar (Doha, Al Wakrah, and Al Khor). Convenient sampling will be used to recruit 753 participants. Descriptive and inferential statistics will be performed using SPSS. Study 2: This qualitative study will gain insight on; 1) how Arabic women view and participate in breast cancer screening activities, 2) how social, cultural, historical, and economic influences affect breast cancer screening for Arab women, the access to screening services, and social support networks in place, and 3) what intervention strategies will increase awareness of early detection and participation in breast cancer screening among Arab women. Purposive sampling will be used. Qualitative in-depth interviews will be individually conducted with Arab women, men, and healthcare providers. Qualitative data analysis will be performed. Although the results are not available at the present time, we will discuss how the information obtained from both the quantitative and qualitative studies will be used to develop culturally appropriate and effective intervention strategies and services to meet the preventative care needs of Arab women living in the State of Qatar with the aim of decreasing the seriousness and prevalence of breast cancer among them.

Background Despite rising breast cancer incidence and mortality rates, breast cancer screening (BCS) rates among women in Qatar remain low. Previous studies indicate the need to better understand the many complex beliefs, values, and attitudes that influence Arab women’s health seeking behavior for the development of culturally appropriate and effective intervention strategies to address breast cancer in the Middle East. This study investigates beliefs, attitudes, and BCS practices of Arabic-speaking women in Qatar. Methods A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) Arabic-speaking female Qatari citizens and non-Qatari residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Associations between beliefs and BCS practice were estimated using chi-square tests and multivariate logistic regression analyses. Participants who adhered to BCS guidelines (BCS practice = Yes) were compared to those who did not (BCS practice = No). Results In addition to low levels of awareness and low participation rates in BCS, one quarter of the participants stated their doctors talked to them about breast cancer, and less than half of the women interviewed believed breast cancer can be prevented. Women who engaged in BCS practice were more likely to have a doctor who talked to them about breast cancer, to believe they were in good–excellent health, that cancer can be prevented, or that cancer might be hereditary. The majority wanted to know if they had cancer and felt their health care needs were being met. The main reasons given for not planning BCS were lack of a doctor’s recommendation, fear, and embarrassment. Conclusions These findings indicate that a variety of channels (health care providers, media, breast cancer survivors, community leaders) should be utilized to create culturally appropriate breast cancer intervention programs and increased awareness of breast cancer, BCS, and the benefits of early detection of breast cancer. Employment of these measures will reduce breast cancer mortality rates among Arabic-speaking women living in the State of Qatar.