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Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda

OBJECTIVE: To evaluate whether integrating breast and cervical cancer screening in Rwanda’s Women’s Cancer Early Detection Program led to early breast cancer diagnoses in asymptomatic women. METHODS: Launched in three districts in 2018–2019, the early detection programme offered clinical breast exam...

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Autores principales: Pace, Lydia E, Hagenimana, Marc, Dusengimana, Jean-Marie Vianney, Balinda, Jean Paul, Benewe, Origene, Rugema, Vestine, de Dieu Uwihaye, Jean, Fata, Amanda, Shyirambere, Cyprien, Shulman, Lawrence N, Keating, Nancy L, Uwinkindi, Francois
Formato: Online Artículo Texto
Lenguaje:English
Publicado: World Health Organization 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10300777/
https://www.ncbi.nlm.nih.gov/pubmed/37397178
http://dx.doi.org/10.2471/BLT.22.289599
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author Pace, Lydia E
Hagenimana, Marc
Dusengimana, Jean-Marie Vianney
Balinda, Jean Paul
Benewe, Origene
Rugema, Vestine
de Dieu Uwihaye, Jean
Fata, Amanda
Shyirambere, Cyprien
Shulman, Lawrence N
Keating, Nancy L
Uwinkindi, Francois
author_facet Pace, Lydia E
Hagenimana, Marc
Dusengimana, Jean-Marie Vianney
Balinda, Jean Paul
Benewe, Origene
Rugema, Vestine
de Dieu Uwihaye, Jean
Fata, Amanda
Shyirambere, Cyprien
Shulman, Lawrence N
Keating, Nancy L
Uwinkindi, Francois
author_sort Pace, Lydia E
collection PubMed
description OBJECTIVE: To evaluate whether integrating breast and cervical cancer screening in Rwanda’s Women’s Cancer Early Detection Program led to early breast cancer diagnoses in asymptomatic women. METHODS: Launched in three districts in 2018–2019, the early detection programme offered clinical breast examination screening for all women receiving cervical cancer screening, and diagnostic breast examination for women with breast cancer symptoms. Women with abnormal breast examinations were referred to district hospitals and then to referral hospitals if needed. We examined how often clinics were held, patient volumes and number of referrals. We also examined intervals between referrals and visits to the next care level and, among women diagnosed with cancer, their initial reasons for seeking care. FINDINGS: Health centres held clinics > 68% of the weeks. Overall, 9763 women received cervical cancer screening and clinical breast examination and 7616 received breast examination alone. Of 585 women referred from health centres, 436 (74.5%) visited the district hospital after a median of 9 days (interquartile range, IQR: 3–19). Of 200 women referred to referral hospitals, 179 (89.5%) attended after a median of 11 days (IQR: 4–18). Of 29 women diagnosed with breast cancer, 19 were ≥ 50 years and 23 had stage III or stage IV disease. All women with breast cancer whose reasons for seeking care were known (23 women) had experienced breast cancer symptoms. CONCLUSION: In the short-term, integrating clinical breast examination with cervical cancer screening was not associated with detection of early-stage breast cancer among asymptomatic women. Priority should be given to encouraging women to seek timely care for symptoms.
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spelling pubmed-103007772023-07-01 Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda Pace, Lydia E Hagenimana, Marc Dusengimana, Jean-Marie Vianney Balinda, Jean Paul Benewe, Origene Rugema, Vestine de Dieu Uwihaye, Jean Fata, Amanda Shyirambere, Cyprien Shulman, Lawrence N Keating, Nancy L Uwinkindi, Francois Bull World Health Organ Research OBJECTIVE: To evaluate whether integrating breast and cervical cancer screening in Rwanda’s Women’s Cancer Early Detection Program led to early breast cancer diagnoses in asymptomatic women. METHODS: Launched in three districts in 2018–2019, the early detection programme offered clinical breast examination screening for all women receiving cervical cancer screening, and diagnostic breast examination for women with breast cancer symptoms. Women with abnormal breast examinations were referred to district hospitals and then to referral hospitals if needed. We examined how often clinics were held, patient volumes and number of referrals. We also examined intervals between referrals and visits to the next care level and, among women diagnosed with cancer, their initial reasons for seeking care. FINDINGS: Health centres held clinics > 68% of the weeks. Overall, 9763 women received cervical cancer screening and clinical breast examination and 7616 received breast examination alone. Of 585 women referred from health centres, 436 (74.5%) visited the district hospital after a median of 9 days (interquartile range, IQR: 3–19). Of 200 women referred to referral hospitals, 179 (89.5%) attended after a median of 11 days (IQR: 4–18). Of 29 women diagnosed with breast cancer, 19 were ≥ 50 years and 23 had stage III or stage IV disease. All women with breast cancer whose reasons for seeking care were known (23 women) had experienced breast cancer symptoms. CONCLUSION: In the short-term, integrating clinical breast examination with cervical cancer screening was not associated with detection of early-stage breast cancer among asymptomatic women. Priority should be given to encouraging women to seek timely care for symptoms. World Health Organization 2023-07-01 2023-05-26 /pmc/articles/PMC10300777/ /pubmed/37397178 http://dx.doi.org/10.2471/BLT.22.289599 Text en (c) 2023 The authors; licensee World Health Organization. https://creativecommons.org/licenses/by/3.0/igo/This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode (https://creativecommons.org/licenses/by/3.0/igo/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.
spellingShingle Research
Pace, Lydia E
Hagenimana, Marc
Dusengimana, Jean-Marie Vianney
Balinda, Jean Paul
Benewe, Origene
Rugema, Vestine
de Dieu Uwihaye, Jean
Fata, Amanda
Shyirambere, Cyprien
Shulman, Lawrence N
Keating, Nancy L
Uwinkindi, Francois
Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda
title Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda
title_full Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda
title_fullStr Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda
title_full_unstemmed Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda
title_short Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda
title_sort implementation research: including breast examinations in a cervical cancer screening programme, rwanda
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10300777/
https://www.ncbi.nlm.nih.gov/pubmed/37397178
http://dx.doi.org/10.2471/BLT.22.289599
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