Overview in Breast Cancer Screening in Lebanon

Abstract

Breast cancer (BC) is the most common cancer in women and men combined, and it is the second cause of cancer deaths in women after lung cancer. In Lebanon, the same epidemiological profile applies where BC is the leading cancer among Lebanese females, representing 38.2% of all cancer cases. As per the Center for Disease Control, there was a decline in BC mortality rate from 2003 to 2012 reflecting the adoption of national mammographic screening as the gold standard for BC detection by Western countries. The aim of this review study is to summarize current recommendations for BC screening and the available modalities for detecting BC in different countries, particularly in Lebanon. It also aims at exploring the impact of screening campaigns on BC early stage diagnosis in Lebanon. Despite the considerable debates whether screening mammograms provides more harm than benefits, screening awareness should be stressed since its benefits far outweigh its risks. In fact, the majority of BC mortality cases in Western countries are non-preventable by the use of screening mammograms alone. As such, Lebanon adopted a public focus on education and awareness campaigns encouraging early BC screening. Several studies showed the impact of early detection that is reflected by an increase in early stage disease and a decrease in more aggressive stages. Further studies should shed the light on the effect of awareness campaigns on early breast cancer diagnosis and clinical down staging at a national scope; therefore, having readily available data on pre- and post-adoption of screening campaigns is crucial for analyzing trends in mortality of breast cancer origin and reduction in advanced stages diseases. There is still room for future studies evaluating post-campaigns knowledge, attitudes, and practices of women having participated, emphasizing on the barriers refraining Lebanese women to contribute in BC screening campaigns.

Burden of female breast cancer in the Middle East and North Africa region, 1990–2019

“…The differences between the countries, in terms of the incidence and burden of breast cancer, could be due to the different levels of exposure or the prevalence of risk factors in each country, implementation of screening programs, accessibility to the screening programs in different areas of a country, willingness of people to participate in these programs or improvements in the cancer registries [ 14 , 17 ]. Moreover, Lebanon has developed breast cancer screening guidelines for females over 40 years of age, which recommends annual mammography for those without a family history of breast cancer and annual screening 10 years before the age at which cancer was first diagnosed in those with a family history of breast cancer [ 18 ]. Furthermore, since 2002 the Lebanese Ministry of Public Health has held annual screening and awareness campaigns for females between October and December [ 18 ].…”

“…Moreover, Lebanon has developed breast cancer screening guidelines for females over 40 years of age, which recommends annual mammography for those without a family history of breast cancer and annual screening 10 years before the age at which cancer was first diagnosed in those with a family history of breast cancer [ 18 ]. Furthermore, since 2002 the Lebanese Ministry of Public Health has held annual screening and awareness campaigns for females between October and December [ 18 ]. The effects of conflict and turbulence in the region must also be taken into consideration.…”

Nutrition Knowledge, Attitudes, and Lifestyle Practices That May Lead to Breast Cancer Risk Reduction among Female University Students in Lebanon

“…Regarding knowledge, the high prevalence of poor knowledge in relation to BC risk reduction revealed in this study could be attributed to the limited presence of national public health awareness campaigns in the country emphasizing the crucial role of nutrition in decreasing the risk of BC. The annual BC screening campaigns initiated by the Ministry of Public health (MOPH) since 2002 have not focused on nutrition [57], thus revealing a gap in addressing the nutrition aspect of BC risk reduction among young women in the country. Additionally, although the Lebanese National Cancer Plan (2023-2028) released by the MOPH mentioned "improving dietary habits and preventing obesity-related cancers" through educational campaigns [58], the extent to which these are implemented remains unknown.…”

Sociodemographic Factors Associated with Breast Cancer Screening Among Women in Serbia, National Health Survey

“…The themes are: high perceived barriers versus benefits, including fear of the breast cancer screening procedure and its possible out-comes, personal challenges that impede screening attendance and paying for screening and treatment, and low perceived susceptibility to breast cancer (16). Low-and middle-income countries (LMICs) grapple with restricted financial resources, apportioning relatively smaller segments to healthcare budgets (17). Elevating awareness regarding breast health, encompassing prevalent cancers, holds the potential to prompt symptomatic women to seek healthcare facilities at earlier stages.…”