General Surgery Resident Indiana University - - Indianapolis, IN Indianapolis, Indiana, United States
Disclosure: Disclosure information not submitted.
Participants should be aware of the following financial/non-financial relationships:
Manisha Bhatia, MD: Disclosure information not submitted.
Introduction: Patients with breast cancer, the most common cancer in Kenya, predominantly present with stage III and IV disease. To promote early-stage diagnosis, we implemented a breast health awareness program in western Kenya. The aim of this study was to understand health-seeking behavior by comparing patients who access breast cancer screening at health fair mass screening events with those who access facility-based screenings.
Methods: This is a retrospective chart review of all individuals who underwent breast cancer screening via physical exam at a ministry of health facility in western Kenya. From 2017-2021, the program hosted mass screening events advertised to communities and trained nurses at health facilities to complete clinical breast exams (CBE) to target individual patients. Results were analyzed using Chi-Square and Kruskal-Walis tests with an α< 0.05.
Results: Over five years, 46023 patients underwent breast cancer screening via clinical breast exam, with 62.5% (n=28,767) presenting during a mass screening event. Patients who presented to the mass screening events were younger (38 vs 43 years, p< 0.0001) and had a higher rate of risk factors including alcohol-use (p< 0.0001), tobacco-use (p< 0.0001), HIV infections (p< 0.0001) or family history of breast cancer before the age of 50 (p< 0.01). Only 0.77% (n=356) presented due to symptoms of pain, swelling, or skin or nipple changes, and most patients with symptoms presented to a mass screening event (p< 0.0001). Only 7.7% of our entire cohort underwent 2 or more screenings within the five-year period. The patients from mass screening events wereless likely to undergo repeat screening, and if they did, they underwent repeat screening later (1.4 vs 1.2 years, p< 0.001).
Conclusions: Patients with more risk factors and symptoms are more likely to come to mass screening events but less likely to undergo repeat screening, suggesting the benefits of broad advertisement for health fairs in promoting breast health awareness are limited to the single event. Overall, the poor rates of repeat screenings indicate additional resources should be allocated to educate patients to continue breast cancer screening at local facilities when mass screenings are unavailable.
Learning Objectives:
Upon completion, the learner will compare the individuals who present to health fair breast cancer screenings with those that present to facility-based breast cancer screenings
Upon completion, the learner will extrapolate further education must be provided to encourage consistent breast cancer screening
Upon completion, the learner will be able to describe the breast cancer screening processes and the prevalence of breast cancer within this cohort
