Results of a pilot programme of mammographic breast cancer screening in the Western Cape

Apffelstaedt, Justus; Hattingh, Retha; Baatjes, Karin; Wessels, Natalie

doi:10.7196/samj.7242

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…Examples of operations of MSUs in regions distant from centralized services include cervical cancer screening in tents in the Andes Mountains of Peru (26); a mammography unit transported by boat and plane to reach Arctic regions in Canada (14); an MSU mammography program serving residents of 26 inhabited islands in Scotland (28); a semi-mobile colonoscopy program for high-risk individuals in South Africa residing over 500 km away from the nearest hospital (29); and MSU interventions for breast and cervical cancer in the rural interior and Amazonian states of Brazil (21,30). In addition, MSUs fill a unique niche in urban areas by targeting underscreened groups who may be within a reasonable physical proximity to a fixed clinic, but less likely to access services due costs, awareness, and perceived barriers (26,(31)(32)(33)(34)(35)(36)(37).…”

Section: Mechanisms For Increasing Delivery Access and Demand For Smentioning

confidence: 99%

Mobile Screening Units for the Early Detection of Cancer: A Systematic Review

Greenwald

El‐Zein

Bouten

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Mobile screening units (MSUs) provide cancer screening services outside of fixed clinical sites, thereby increasing access to early detection services. We conducted a systematic review of the performance of MSUs for the early detection of cancer. Databases (MEDLINE, EMBASE, Cochrane Library, WHO Global Health Library, Web of Science, PsycINFO) were searched up to July 2015. Studies describing screening for breast, cervical, and colon cancer using MSUs were included. Data were collected for operational aspects including the performance of exams, screening tests used, and outcomes of case detection. Of 268 identified studies, 78 were included. Studies investigated screening for cancers including breast ( = 55), cervical ( = 12), colon ( = 1), and multiphasic screening for multiple cancers ( = 10). The median number of screening exams performed per intervention was 1,767 (interquartile range 5,656-38,233). Programs operated in 20 countries, mostly in North America (36%) and Europe (36%); 52% served mixed rural/urban regions, while 35% and 13% served rural or urban regions, respectfully. We conclude that MSUs have served to expand access to screening in diverse contexts. However, further research on the implementation of MSUs in low-resource settings and health economic research on cost-effectiveness of MSUs compared with fixed clinics to inform policymakers is needed. .

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Section: Mechanisms For Increasing Delivery Access and Demand For Smentioning

confidence: 99%

Mobile Screening Units for the Early Detection of Cancer: A Systematic Review

Greenwald

El‐Zein

Bouten

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Vang et al [ 58 ] emphasized certain deficiencies and obstacles associated with mobile units, including issues of image quality, incomplete scans, elevated recall rates, and limited integration of advanced technologies like film-screen, full-field digital, and tomosynthesis. Despite the increasing global implementation of mobile mammographic units, particularly in regions such as sub-Saharan Africa and South America, challenges tied to sociodemographic factors and recall rates persist, thereby impacting screening quality and adherence [ 59 , 60 ].…”

Section: Implement Teleradiology Services Remote Support and Global I...mentioning

confidence: 99%

Disparities in Breast Cancer Diagnostics: How Radiologists Can Level the Inequalities

Pesapane,

Tantrige,

Rotili

et al. 2023

Cancers

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Access to medical imaging is pivotal in healthcare, playing a crucial role in the prevention, diagnosis, and management of diseases. However, disparities persist in this scenario, disproportionately affecting marginalized communities, racial and ethnic minorities, and individuals facing linguistic or cultural barriers. This paper critically assesses methods to mitigate these disparities, with a focus on breast cancer screening. We underscore scientific mobility as a vital tool for radiologists to advocate for healthcare policy changes: it not only enhances diversity and cultural competence within the radiology community but also fosters international cooperation and knowledge exchange among healthcare institutions. Efforts to ensure cultural competency among radiologists are discussed, including ongoing cultural education, sensitivity training, and workforce diversification. These initiatives are key to improving patient communication and reducing healthcare disparities. This paper also highlights the crucial role of policy changes and legislation in promoting equal access to essential screening services like mammography. We explore the challenges and potential of teleradiology in improving access to medical imaging in remote and underserved areas. In the era of artificial intelligence, this paper emphasizes the necessity of validating its models across a spectrum of populations to prevent bias and achieve equitable healthcare outcomes. Finally, the importance of international collaboration is illustrated, showcasing its role in sharing insights and strategies to overcome global access barriers in medical imaging. Overall, this paper offers a comprehensive overview of the challenges related to disparities in medical imaging access and proposes actionable strategies to address these challenges, aiming for equitable healthcare delivery.

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Breast cancer screening in sub-Saharan Africa: a systematic review and ethical appraisal

2022

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Background The aim of this systematic review was to evaluate the evidence and clinical outcomes of screening interventions and implementation trials in sub-Saharan Africa (SSA) and also appraise some ethical issues related to screening in the region through quantitative and qualitative narrative synthesis of the literature. Methods We searched Pubmed, OvidMEDLINE, Embase, and Web of Science to identify studies published on breast cancer screening interventions and outcomes in SSA. Descriptive statistics were used to summarize the frequency and proportions of extracted variables, and narrative syntheses was used to evaluate the clinical outcomes of the different screening modalities. The mixed methods appraisal tool was used to assess the quality of studies included in the review. Results Fifteen studies were included, which consisted of 72,572 women in ten countries in SSA. 63% (8/15) of the included publications evaluated Clinical Breast Examination (CBE), 47% (7/15) evaluated mammography and 7% (1/15) evaluated ultrasound screening. The cancer detection rate was < 1/1000 to 3.3/1000 and 3.3/100 to 56/1000 for CBE and mammography screening respectively. There was a lot of heterogeneity in CBE methods, target age for screening and no clear documentation of screening interval. Cost-effective analyses showed that CBE screening linked to comprehensive cancer care is most cost effective. There was limited discussion of the ethics of screening, including the possible harms of screening in the absence of linkage to care. The gap between conducting good screening program and the appropriate follow-up with diagnosis and treatment remains one of the major challenges of screening in SSA. Discussion There is insufficient real-world data to support the systematic implementation of national breast cancer screening in SSA. Further research is needed to answer important questions about screening, and national and international partnerships are needed to ensure that appropriate diagnostic and treatment modalities are available to patients who screen positive.

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Results of a pilot programme of mammographic breast cancer screening in the Western Cape

Cited by 4 publications

References 9 publications

Mobile Screening Units for the Early Detection of Cancer: A Systematic Review

Mobile Screening Units for the Early Detection of Cancer: A Systematic Review

Disparities in Breast Cancer Diagnostics: How Radiologists Can Level the Inequalities

Breast cancer screening in sub-Saharan Africa: a systematic review and ethical appraisal

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