Abstract
BackgroundGiven the increasing burden of breast cancer in the low- and middle-income countries, cost-effective approaches are needed to improve the early detection of breast cancer in these continents. Global policies and guidelines are now placing much emphasis on promoting early detection of breast cancer through integrated education and screening interventions. The proposed systematic review aims to map evidence on hospital-based breast cancer education, breast self-examination, and clinical breast examination services for women in low- and middle-income countries.Methods/designWe will conduct a systematic review of peer-reviewed studies on hospital-based breast cancer prevention intervention (breast cancer education, breast self-examination, and clinical breast examination) for women in low- and middle-income countries. An electronic search will be conducted in the following electronic databases CINAHL Plus with full text (EBSCOhost), MEDLINE with full-text (EBSCOhost) PsychINFO (EBSCOhost), and PubMed. Articles will also be searched through the “Cited by” search and citations included in the reference list of included articles. A two-stage mapping approach will be conducted. The first stage will involve screening studies through assessing their titles. Also, we will screen abstracts of identified studies descriptively and by focus and methods as dictated by the inclusion and exclusion criteria. The second stage will include extraction of data from eligible studies. A parallel screening and data extraction will be conducted by two reviewers. The quality of included studies will be assessed using the mixed methods appraisal tool (MMAT). A narrative account of the data extracted from the included studies will be analyzed using the thematic analysis.DiscussionWe hope to find relevant studies reporting evidence on promoting prevention and the early detection of breast cancer among women in a hospital-based education and screening interventions in low- and middle-income countries. The evidence obtained from the included studies when summarized will help guide future research. The study results will be disseminated electronically and in print. Also, it will be presented at conferences related to breast cancer.Systematic review registrationThe protocol has been registered with PROSPERO, with registration number CRD42017077818.
Highlights
Given the increasing burden of breast cancer in the low- and middle-income countries, cost-effective approaches are needed to improve the early detection of breast cancer in these continents
Evidence projects that over 19.5 million new cases of Breast cancer (BC) will be diagnosed among women globally by the year 2024, of which 55% will occur in low- and middle-income countries (LMICs) [3]
Despite that there is a growing recognition that health systems should develop and integrate appropriate, cost-effective cancer prevention, and early detection interventions into existing non-communicable disease (NCD) programs especially in LMICs where most curable cancers are initially diagnosed at an advanced stage [6, 8, 12, 23]; there seems to be paucity of evidence on such models or interventions for BC for healthy women in LMICs
Summary
Given the increasing burden of breast cancer in the low- and middle-income countries, cost-effective approaches are needed to improve the early detection of breast cancer in these continents. The proposed systematic review aims to map evidence on hospital-based breast cancer education, breast self-examination, and clinical breast examination services for women in low- and middle-income countries. Global policies and guidelines suggest prevention as the important priority and the cost-effective approach to curb the world’s burden of BC; especially, in LMICs where inadequate trained oncology health personnel, poor infrastructure, and economical and geographical barriers to BC treatment exist [4, 6,7,8,9]. The use of active interventions such as breast cancer education (BCE), breast self-examination (BSE), and clinical breast examination (CBE) has shown to decrease the incidence, late presentation, and death rates of BC among women [11, 12]. BCE, BSE, and CBE seem the effective prevention/control and early detection measures for BC in limited resource countries [6, 12,13,14]
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