Early Detection of Breast Cancer in Gulf Cooperation Council Countries: Case Studies

Abstract

Background: Breast cancer is the most frequently diagnosed cancer among women in Gulf countries. Although breast cancer incidence rates in the Gulf are substantially lower than rates in developed countries, yet an increasing trend is evident. Most breast cancers are diagnosed at an advanced stage, only 23.3% of patients presented with localized tumors and less than 2% with in situ, making improvements to early detection of breast cancer a priority. There has been good progress and investment in early detection of breast cancer program in Gulf countries based on augmenting breast cancer awareness through public education, investing in mammographic based screening and improving infrastructure. Nevertheless, development of breast cancer early detection programs in most of the Gulf countries has been based on sporadic investments and actions rather than on a planned, approved and resource-linked national control plan. In many instances the scientific evidence-base for such investments has not been obtained and the evaluation of implemented programs is lacking. Aim: To review breast cancer screening, early detection practices in Gulf region, outlines enablers and identifies priorities for scaling up early detection programs in Gulf countries. Methods: The study relies heavily on review of published literature and data gathered through interview and discussion with key informants from government and nongovernment institutions at the studied countries. Results: Four case studies will be discussed from Bahrain, UAE, Kuwait and Saudi Arabia. Conclusion: Breast cancer is a major and increasing problem in Gulf countries, but it is still largely diagnosed at an advanced stage. While mammography based screening programs have been initiated in Gulf countries, however they generally have limited uptake, with very little evidence to support their effectiveness, largely because their attempts at education on the curability of breast cancer, and their endeavors to dispel the prevalent myths on breast cancer, have not been sufficiently successful. Thus, it is essential that the highest priority in each country should be improving awareness, early diagnosis of breast cancer, by public and professional education. This will require considerable investment in training primary care professionals, organizing referral mechanisms and setting up multidisciplinary breast cancer diagnosis and treatment facilities across the countries. While population-level screening for breast cancer is feasible in Gulf countries, yet careful consideration for available resources is critical for success. Moreover, it is important to pilot any screening programs prior to national roll-out.