Breast cancer early detection : a phased approach to implementation

Q1Q1When breast cancer is detected and treated early, the chances of survival are very high. However, women in many settings face complex barriers to early detection, including social, economic, geographic, and other interrelated factors, which can limit their access to timely, affordable, and effective breast health care services. Previously, the Breast Health Global Initiative (BHGI) developed resource-stratified guidelines for the early detection and diagnosis of breast cancer. In this consensus article from the sixth BHGI Global Summit held in October 2018, the authors describe phases of early detection program development, beginning with management strategies required for the diagnosis of clinically detectable disease based on awareness education and technical training, history and physical examination, and accurate tissue diagnosis. The core issues address include finance and governance, which pertain to successful planning, implementation, and the iterative process of program improvement and are needed for a breast cancer early detection program to succeed in any resource setting. Examples are presented of implementation, process, and clinical outcome metrics that assist in program implementation monitoring. Country case examples are presented to highlight the challenges and opportunities of implementing successful breast cancer early detection programs, and the complex interplay of barriers and facilitators to achieving early detection for breast cancer in real-world settings are considered.https://scholar.google.com/citations?user=xFiKCkMAAAAJ&hl=eshttp://scienti.colciencias.gov.co:8081/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000264474Revista Nacional - Indexad

HEALTH SEEKING BEHAVIOR AMONG CANCER PATIENTS ATTENDING OCEAN ROAD CANCER INSTITUTE, TANZANIA

Objectives: To characterize cancer patients and to determine the associated health seeking behaviours. Methods: Between September 2005 and February 2006, we collected data using structured and semi-structured interviews among new cancer patients attending the ORCI. Findings are summarized using univarite and bivariate analyses. Results: There were 330 cancer patients during the study period. The mean age was 48 (SD = 13.5) years ranging between 21 and 84 years. The majority, 205 (62.1%), were females. More than two thirds of all patients, that is 225 (68.2%), presented at the ORCI at advanced stages of disease. Many patients reported to have neither heard, 193 (58.5%), nor to know cancer symptoms, 203 (61.5%). Only 185 (56.1%) of all patients reported their willingness to disclose and a freedom to talk about the disease. Risk factors for cancer staging were sex, patient’s education status, awareness and knowledge of disease symptoms. Conclusions: Interventions targeted to improve health care seeking behaviour among cancer patients need to include health education and sensitization specifically of cancer disease, establish a strong referral mechanisms at primary health level and to start a population cancer registry for monitoring and evaluation purposes