Breast cancer screening discrepancies in different countries associated with different outcomes

1. In Brasil, Russia, India, China, and South Africa, the availability of breast cancer screening programs was associated with a significant reduction in breast cancer mortality. 

Evidence rating level: 3 (Average)

Breast cancer is the greatest contributor to cancer-related morbidity and mortality for females across the world. Breast cancer screening (BCS) is an effective strategy for detecting asymptomatic people with breast cancer, allowing for early intervention. In Brazil, Russa, India, China, and South Africa (BRICS countries), which collectively account for approximately half of the global population, the association between BCS and breast cancer-related morbidity and mortality has not been well established. Data were collected from the Global Burden of Disease study 2019 on breast cancer incidence, mortality, and disability-adjusted life years (DALYs), as well as BCS methods and availability. The availability of mammography, as opposed to only self or clinical breast exams, was associated with a decreased mortality rate (− 2.64, p < 0.001). The presence of national or regional mammography programs reduced mortality compared to having none or only a pilot screening program (national − 1.52, p < 0.001; regional − 1.40, p < 0.001). Other factors associated with increased breast cancer-related mortality and DALYs included cardiovascular disease, smoking, and high BMI. A limitation of this study is that only the availability of breast cancer screening programs was assessed, not the utilization of such programs. As well, it is difficult to study the availability of BCS programs as an independent variable, given that the presence of these programs is likely associated with other factors, including higher income countries or regions. Similarly, the availability of treatment for breast cancer in different regions is also likely to impact the mortality rates. Overall, these findings support the implementation of breast cancer screening programs that go beyond self and clinical breast exams. 

Click to read the study in BMC Medicine

Image: PD

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