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Impact of clinical breast examination-based screening program on care pathway, stage at diagnosis, nature of treatment, and overall survival among breast cancer patients in Morocco.

Authors :
Selmouni F
Bendahhou K
Sauvaget C
Abahssain H
Lucas E
Muwonge R
Mimouni H
Ismaili R
Bidar S
Benkaddour FZ
Abousselham L
Chami Khazraji Y
Belakhel L
Basu P
Source :
Cancer [Cancer] 2024 Oct 01; Vol. 130 (19), pp. 3353-3363. Date of Electronic Publication: 2024 Jun 04.
Publication Year :
2024

Abstract

Background: This study aimed to indirectly examine whether the implementation of clinical breast examination-based screening program in Morocco has been successful in downstaging and improving survival rates. Breast cancer patients detected through the screening pathway were compared with those detected through self-referral over the same period in terms of cancer stage at diagnosis, tumor characteristics, care delays, and survival.<br />Methods: A prospective observational study was conducted between April 2019 and August 2020 at two major public oncology centers.<br />Results: A total of 896 women with confirmed breast cancer were recruited (483 were program-referred and 413 were self-referred). The authors did not report any significant difference between the two groups in terms of stage at diagnosis, molecular profile, or histopathological grade. Early-stage cancer (stage I-II) was detected in 55.7% of self-referred participants compared to 55.5% of program-referred participants. Median intervals between symptom recognition, pathological diagnosis, and treatment initiation were not significantly different between the two groups. Similarly, survival after treatment showed no significant difference between patients screened by the program and self-referred patients. The 3-year survival rate after treatment was 94.5% for patients referred through the program and 88.6% for patients not referred through the program (p = .16).<br />Conclusions: This study highlights the importance of equitable and timely access to high-quality diagnosis and treatment facilities, leading to substantial downstaging and enhanced survival rates. Continued efforts to improve quality and expand coverage to include asymptomatic women will consolidate the health infrastructure gains achieved by the Moroccan breast cancer screening program.<br /> (© 2024 World Health Organization; licensed by American Cancer Society. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Details

Language :
English
ISSN :
1097-0142
Volume :
130
Issue :
19
Database :
MEDLINE
Journal :
Cancer
Publication Type :
Academic Journal
Accession number :
38837217
Full Text :
https://doi.org/10.1002/cncr.35419