Screening mammography with special reference to guidelines in South Africa

Lipschitz, Shirley

doi:10.4102/sajr.v22i2.1370

Cited by 9 publications

(19 citation statements)

References 39 publications

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“… 35 In most HICs, mammograms are typically recommended for women over the age of 40 and is included as part of preventive care thus, making it available to most women. 12 36 In contrast, most countries in SSA lack national screening programmes and have insufficient funds to screen all eligible women. 12 36 Despite scarce financial resources, the Cancer Association of South Africa guidelines advocate for a mammogram every year for all women aged 40 years and older for the purpose of asymptomatic breast cancer screening and recommends discussion of any breast health problems with primary healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

“…9 Higher survival rates of breast cancer in HICs over the past 25 years have been associated with improved adjuvant systemic therapy and advanced early detection via mammography, which is the only breast cancer screening ever shown in randomised controlled trials to reduce breast cancer-specific mortality by 15%-30%. [10][11][12][13][14] This is in contrast to LMICs such as much of SSA with very limited resources where mammography screening is not yet available on a population-based level. 15 The major attributable factors to a low survival rate of breast cancer in SSA include late-stage diagnosis and lack of access to quality healthcare.…”

Section: Introductionmentioning

confidence: 98%

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Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Ssentongo

Agbese

et al. 2020

BMJ Open

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ObjectivesBreast cancer is the most prevalent cancer and the second leading cause of cancer-related deaths among women after cervical cancer in much of sub-Saharan Africa. This study aims to examine the prevalence and sociodemographic–socioeconomic factors associated with breast cancer screening among women of reproductive age in sub-Saharan Africa.DesignA weighted population-based cross-sectional study using Demographic and Health Surveys (DHS) data. We used all available data on breast cancer screening from the DHS for four sub-Saharan African countries (Burkina Faso, Ivory Coast, Kenya and Namibia). Breast cancer screening was the outcome of interest for this study. Multivariable Poisson regression was used to identify independent factors associated with breast cancer screening.SettingFour countries participating in the DHS from 2010 to 2014 with data on breast cancer screening.ParticipantsWomen of reproductive age 15–49 years (N=39 646).ResultsThe overall prevalence of breast cancer screening was only 12.9% during the study period, ranging from 5.2% in Ivory Coast to 23.1% in Namibia. Factors associated with breast cancer screening were secondary/higher education with adjusted prevalence ratio (adjusted PR)=2.33 (95% CI: 2.05 to 2.66) compared with no education; older participants, 35–49 years (adjusted PR=1.73, 95% CI : 1.56 to 1.91) compared with younger participants 15–24 years; health insurance coverage (adjusted PR=1.57, 95% CI: 1.47 to 1.68) compared with those with no health insurance and highest socioeconomic status (adjusted PR=1.33, 95% CI : 1.19 to 1.49) compared with lowest socioeconomic status.ConclusionDespite high breast cancer mortality rates in sub-Saharan Africa, the prevalence of breast cancer screening is substantially low and varies gradually across countries and in relation to factors such as education, age, health insurance coverage and household wealth index level. These results highlight the need for increased efforts to improve the uptake of breast cancer screening in sub-Saharan Africa.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Ssentongo

Agbese

et al. 2020

BMJ Open

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“…Across the globe there is conflicting data and considerable debate on what these recommendations should entail, particularly in the 40–49 year age group. 10 The ACR recommends women of average risk for the development of breast cancer to commence annual screening mammography from the age of 40. 11 The United States Preventative Services Task Force (USPSTF) advises biennial screening mammography within the age group 50–74, with the recommendation that women aged 40–49 can have optional screening after discussion with their healthcare provider.…”

Section: Introductionmentioning

confidence: 99%

“…The Radiological Society of South Africa (RSSA) and Breast Imaging Society of South Africa (BISSA) advise annual screening from the age of 40, which is in accordance with the recommendation from the ACR. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

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Breast imaging at Chris Hani Baragwanath Academic Hospital: A clinically relevant audit

Warnich

Viljoen

Kuehnast

2020

South African Journal of Radiology

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Background: Breast cancer is a major cause of morbidity and mortality worldwide. From experience, we have found that the disease burden at Chris Hani Baragwanath Academic Hospital (CHBAH) is unique with an advanced stage at presentation.Objective: To perform a breast-imaging audit at CHBAH, focused on interpretive performance and disease burden.Method: Demographic and imaging data were retrospectively collected over a 6-month period. Data collected and derived followed the audit-definitions and rules described within the American College of Radiology–breast-imaging reporting and data system (ACR–BI-RADS) atlas (5th edn.). A comparison was made to benchmark values published by the Radiological Society of North America (RSNA).Results: A total of 1549 mammography examinations were analysed. The screening subgroup (n = 808) revealed 11 cancers with a cancer detection rate (CDR) of 13.6 per 1000 studies and a recall rate of 5.94. The diagnostic subgroup (n = 741) revealed 130 cancers with a CDR of 175.4 and an abnormal interpretation rate (AIR) of 39 per 100 studies. Along with the positive predictive values, these performance measures for diagnostic mammography were significantly larger than the RSNA-benchmarks (p 0.0001). In addition, the cancer characteristics showed a greater histological mean tumour length, a lower percentage of minimal cancers (defined as ductal carcinoma in situ [DCIS] and invasive cancers ≤ 1 cm) and fewer nodal-negative cancers (p 0.0001), in keeping with a more advanced loco-regional stage at presentation.Conclusion: The study illustrates the challenges faced by a South African breast-imaging unit confronted with advanced loco-regional disease. The cancer burden is highlighted within a community where there is a lack of national screening mammography. The process of performing a basic, clinically relevant audit is simple and should be a routine practice in breast-imaging units.

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Predictors of breast cancer screening among women of reproductive age in Tanzania: Evidence from DHS 2022

Tibenderana,

Kessy,

Mlaponi

et al. 2024

Preprint

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Background Breast cancer is a global concern, registering 2.3 million new cases and 685,000 deaths in 2020, with projections reaching 4.4 million cases by 2070. In Tanzania, it’s the second leading cause of cancer-related deaths among women, often diagnosed at advanced stages, leading to poor outcomes. Only 5% of women in the country report undergoing breast cancer screening, the aim study is to determine factors associated with breast cancer screening in Tanzania. Methods A cross-sectional study among women of reproductive age in Tanzania, utilizing data from the Demographic and Health Surveys (DHS). We used available data on breast cancer screening the DHS. The outcome of the study was breast cancer screening. To find independent variables associated with breast cancer screening, logistic regression was used. Results After controlling for other factors, the following factors remained significantly associated with breast cancer screening among women of reproductive age; age(AOR=5.33, 95% CI 3.72, 7.63), being wealthy ( AOR=2.34, 95% CI 1.61, 3.38), residing in rural(AOR= 0.59, 95% CI 0.46, 0.763), being educated(AOR= 2.43, 95% CI 1.60, 3.68), being insured(AOR= 2.40, 95% CI 1.89, 3.06), healthcare facility visits in the past 12 months(AOR=1.43, 95% CI 1.14, 1.78) and living in Northern zone( AOR= 2.43, 95% CI 1.42, 4.15) compared to western zone Conclusion Breast cancer screening is still under-utilized and have shown to be marginalized in women of reproductive age. Policies to address disparities, comprehensive health education and awareness campaigns are instrumental to increase utilization and reduction of burden of breast cancers in Tanzania

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Screening mammography with special reference to guidelines in South Africa

Cited by 9 publications

References 39 publications

Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study

Breast imaging at Chris Hani Baragwanath Academic Hospital: A clinically relevant audit

Predictors of breast cancer screening among women of reproductive age in Tanzania: Evidence from DHS 2022

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