DOI QR코드

DOI QR Code

Breast Cancer Screening in Morocco: Performance Indicators During Two Years of an Organized Programme

  • Fakir, Samira El (Department of Epidemiology and Public Health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah) ;
  • Najdi, Adil (Department of Epidemiology and Public Health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah) ;
  • Khazraji, Youssef Chami (Fondation Lalla Salma Prevention and Treatment of Cancers) ;
  • Bennani, Maria (Fondation Lalla Salma Prevention and Treatment of Cancers) ;
  • Belakhel, Latifa (Directory of Epidemiology and Fight against Diseases (DELM)) ;
  • Abousselham, Loubna (Direction of Population, Ministry of Health) ;
  • Lyoussi, Badiaa (Laboratory of Physiology, Pharmacology and Environmental Health, Faculty of Science, University Sidi Mohammed Ben Abdellah) ;
  • Bekkali, Rachid (Fondation Lalla Salma Prevention and Treatment of Cancers) ;
  • Nejjari, Chakib (Department of Epidemiology and Public Health, Faculty of Medicine, University Sidi Mohammed Ben Abdellah)
  • Published : 2015.10.06

Abstract

Background: Breast cancer is commonly diagnosed at late stages in countries with limited resources. In Morocco, breast cancer is ranked the first female cancer (36.1%) and screening methods could reduce the proportion presenting with a late diagnosis. Morocco is currently adopting a breast cancer screening program based on clinical examination at primary health facilities, diagnosis at secondary level and treatment at tertiary level. So far, there is no systematic information on the performance of the screening program for breast cancer in Morocco. The aim of this study was to analyze early performance indicators. Materials and Methods: A retrospective evaluative study conducted in Temara city. The target population was the entire female population aged between 45-70 years. The study was based on process and performance indicators collected at the individual level from the various health structures in Tamara between 2009 and 2011. Results: A total of 2,350 women participated in the screening program; the participation rate was 35.7%. Of these, 76.8% (1,806) were married and 5.2% (106) of this group had a family history of breast cancer. Of the women who attended screening, 9.3% (190) were found to have an abnormal physical examination findings. A total of 260 (12.7%) were referred for a specialist consultation. The positive predictive value of clinical breast examination versus mammography was 23.0%. Forty four (35.5%) of the lesions found on the mammograms were classified as BI-RADs 3; 4 or 5 category. Cancer was found in 4 (1.95%) of the total number of screened women and benign cases represented 0.58%. Conclusions: These first results of the programme are very encouraging, but there is a need to closely monitor performance and to improve programme procedures with the aim of increasing both the participation rate and the proportion of women eligible to attend screening.

Keywords

Breast screening;Morocco;cancer early detection;performance indicators

References

  1. Althuis MD, Dozier JM, Anderson WF, et al (2005). Global trends in breast cancer incidence and mortality 1973-1997. Int J Epidemiol, 34, 405-12 https://doi.org/10.1093/ije/dyh414
  2. Anderson TJ, Lamb J, Alexander F, et al (1986). Comparative pathology of prevalent and incident cancers detected by breast screening. edinburgh breast screening project. Lancet, 8480, 519-23
  3. Autier P, Shannoun F, Scharpantgen A, et al (2002). A breast cancer screening programme operating in a liberal health care system: the Luxembourg mammography programme 1992-1997. Int J Cancer, 97, 828-32 https://doi.org/10.1002/ijc.10161
  4. Baines CJ, Miller AB, Bassett AA (1989). Physical examination. its role as a single screening modality in the canadian national breast screening study. Cancer, 63, 1816-22
  5. Bobo JK, Lee NC, Thames SF (2000). Findings from 752081 clinical breast examinations reported to a national screening program from 1995 through 1998. J Natl Cancer Inst, 92, 971-6 https://doi.org/10.1093/jnci/92.12.971
  6. Boncz I, Sebestyen A, Dobrossy L, et al (2007). The organisation and results of first screening round of the Hungarian nationwide organised breast cancer screening programme. Ann Oncol,18,795-9
  7. Cancer Registry of Greater Casablanca (2012). Registre des cancers du grand Casablanca. 2005-2006-2007
  8. Corbex M, Burton R, Sancho-Garnier H (2012). Breast cancer early detection methods for low and middle income countries,a review of the evidence. Breast,21, 428-34 https://doi.org/10.1016/j.breast.2012.01.002
  9. Donnelly TT, Al-Khater A, Al-Kuwari M, et al (2012) . Breast cancer screening amongst Arabic women living in the State of Qatar: Awareness, knowledge, and participation in screening activities. Avicenna, 2, 1-17 https://doi.org/10.4103/2231-0770.94802
  10. Europe Against Cancer (1996). European Guidelines for Quality Assurance in Mammography Screening
  11. Fracheboud J, de Koning HJ, Boer R, et al (2001). Nationwide breast cancer screening programme fully implemented in The Netherlands. Breast , 10, 6-11 https://doi.org/10.1054/brst.2000.0212
  12. Fondation Lalla Salma Prevention and Treatment of Cancers (2011) .Guide de detection precoce des cancers du sein et du col de l'uterus au Maroc
  13. Jatoi I (1999). Breast cancer screening. Am J Surg ,177,518-24 https://doi.org/10.1016/S0002-9610(99)00096-3
  14. Kaviani A, Majidzadeh K, Vahdaninia MS (2001). Mastalgia in females attending the Iranian Center for breast cancer. Payesh, 1, 57-61
  15. Latarche C, Desandes E, Mayeux D, et al (2004). Delais de prise en charge des patientes atteintes d'un cancer du sein dans un reseau regional de soins en cancerologie : faisabilite d'un programme personnalise de soins. Bulletin du cancer , 91,965- 71
  16. Madlensky L, Goel V, Polzer J, et al (2003). Assessing the evidence for organised cancer screening programmes. Eur J Cancer, 39,1648-53 https://doi.org/10.1016/S0959-8049(03)00315-0
  17. Maxwell Parkin D, Fernandez LM (2006). Use of statistics to assess the global burden of breast cancer. Breast J ,12, S70-S80 https://doi.org/10.1111/j.1075-122X.2006.00205.x
  18. National Cancer Institute-France (2013). Delais de prise en charge des quatre cancers les plus frequents dans plusieurs regions de France en 2011 et 2012 : sein, poumon, colon et prostate
  19. Newton P, Hannay DR, Laver R (1999). The presentation and management of female breast symptoms in general practice in Sheffield. FamPract, 16, 360-5
  20. Nystrom L, Rutqvist LE, Wall S, et al (1993). Breast cancer screening with mammography: overview of Swedish randomized trials. Lancet , 341, 973-8 https://doi.org/10.1016/0140-6736(93)91067-V
  21. Richards MA, West combe AM, Love SB, et al (1999). Influence of delay on survival in patients with breast cancer: a systemic review. Lancet , 353,1119-26 https://doi.org/10.1016/S0140-6736(99)02143-1
  22. Spurgeon P, Barwell F, Kerr D (2000). Waiting times for cancer patients in England after general practitioners' referrals: retrospective national survey. BMJ ,320,838-9 https://doi.org/10.1136/bmj.320.7238.838
  23. Tabar, L, Fagerberg CJ, Gad A, et al (1985). Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the breast.The Lancet,325,829-32 https://doi.org/10.1016/S0140-6736(85)92204-4
  24. Wait SH, Allemand HM (1996). The French breast cancer screening programme. Epidemiological and economic results of the first round of screening. Eur J Public Health , 6, 43-8 https://doi.org/10.1093/eurpub/6.1.43
  25. Wang H, Karesen R, Hervik A, et al (2001). Mammography screening in Norway: results from the first screening round in four counties and cost-effectiveness of a modeled nationwide screening. Cancer Causes Control , 12, 39-45 https://doi.org/10.1023/A:1008999403069
  26. World Health Organization (2011).Global status report on non communicable diseases 2010.

Cited by

  1. Mammographic Screening of Women Attending a Reference Service Center in Southern Brazil vol.17, pp.3, 2016, https://doi.org/10.7314/APJCP.2016.17.3.1385
  2. Breast cancer in Africa: prevalence, treatment options, herbal medicines, and socioeconomic determinants pp.1573-7217, 2017, https://doi.org/10.1007/s10549-017-4408-0
  3. Breast Cancer Screening Program in Morocco: Status of implementation, organization and performance vol.143, pp.12, 2018, https://doi.org/10.1002/ijc.31749
  4. Estimating the incidence of breast cancer in Africa: a systematic review and meta-analysis vol.8, pp.1, 2018, https://doi.org/10.7189/jogh.08.010419