Descriptive Analyses of the National Breast Cancer Screening and Early Detection Program, Kingdom of Saudi Arabia, 2011— 2016 Open Access
Munshi, Nada (Fall 2017)
Abstract
BACKGROUND: Breast cancer (BC) is the most common cancer worldwide; its incidence and mortality rates are high, but have recently dropped in the United States and parts of Western Europe, in part due to BC screening. Unfortunately, there are few BC studies among women in the Middle East and North Africa (MENA). The Kingdom of Saudi Arabia (KSA) – a country in WHO’s Eastern Mediterranean Region Office (EMRO) – where BC has been recognized as a major problem among women for two decades, established a pilot BC screening and early detection (ED) program in 2011. So, for the first time, we reviewed the program, analyzed data from a portion of women screened from 2011 – 2016, and made recommendations to improve the program for the future.
METHODS: The program’s history, goals, and performance were collected through a review of one internal report of the program called: “The suggested expansion plan of the national BC screening and ED program” and key informant interviews of two of the BC screening and ED program staff. Data from an arbitrary portion (N = 8,365) of women (N = 44,553) seen in five KSA Ministry of Health (MoH) BC and ED screening clinics in Riyadh from 2011 to June 30, 2016 were collected; cleaned; organized into three categories: demographic, epidemiologic, and medical; and analyzed using SPSS. Additionally, from 2015 – June 30, 2016 the number of servings of fruit and vegetables and physical activities were collected, cleaned and analyzed.
RESULTS: Over 5,000 women attended the program in 2013; while > 10,000 women attended in 2016, highlighting the program’s acceptability and increasing popularity. Among the 8,365 women interviewed, 84% had been screened for the first time. Most women were Illiterate (30%) or had only primary schooling (18%). Most women (4,902; 59%) were obese. Among the 5,702 women screened from 2015 – June 30, 2016 (in all age categories), 2 – 4 servings of fruit and vegetables was most commonly reported. And 1,423 (26%) women of ≥ 40 years of age reported not engaging in any physical activity.
CONCLUSION: The pilot KSA MoH BC screening program began in 2011 with a successful start. For five years it grew and served the needs of > 40,000 KSA women by providing free BC screening services. Needing education and services about diet and exercise, most (59%) KSA women screened were obese and did not exercise. One limitation was that data were arbitrarily collected from a portion (19%) of the 44,553 women who visited the BC Screening and ED program; therefore, the objective findings described here are not generalizable and should be interpreted with caution. As the program enters stage three (2017 – 2020), we recommend updates in program design and implementation by evaluating the value of each variable collected (including their definitions), systematically recruiting participants, and digitizing data entry. In addition, the program should geographically expand to include women from all KSA cities and establish measures to monitor and evaluate the program.
Table of Contents
Chapter 1: Introduction…………................................................................................... 7
Chapter 2: Literature Review……………...................................................................... 9
Chapter 3: Methods ......................................................................................................17
Study design ……………………………….…………………………………......... 17
Data collection ……………………………….…………………………………...... 17
Data source…………………………………….…………………………………..... 17
Study variables………………………………….………………………………...... 17
Statistical analyses ………………………….…………………………………...... 18
Ethics …....………………………………….……………..……………................... 18
Chapter 4: Results............................................................................. 20
Chapter 5: Discussion........................................................................26
References ....................................................................................... 29
Appendix ......................................................................................... 30
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