New Approach for Early Detection of Breast Cancer in Iran.

Abstract

Abstract Introduction:Approximately 50% of newly diagnosed breast cancers occur in developing countries and it is the most common cancer amongst women in these countries. Majority of patients seek medical help late and in an advanced stage of the disease and there is a lack of national screening program. Moreover, some of these countries suffer from lack of diagnostic and treatment facilities to deal with their symptomatic patients. It seems, therefore, that the pressing need is detection of palpable breast cancer at an early stage.Increasing women's breast cancer awareness by mass education is not only the key to achieve this goal, but it is the basic pre-requisite for implementing the mass screening for breast cancer. Electronic media such as TV programs and Short Message Service (SMS) are easily accessible and relatively cheap in majority of these countries.This study which was designed in Iran and looked at population within one province in this country, aims to study whether the use of electronic media leads to increase patients' awareness and change in their behavior by early presentation and therefore smaller breast tumour on diagnosis and as a result increase in survival.Methods:Semnan province (in the north east of Iran with 588180 populations) was selected as the interventional group and two neighborhood regions with similar population were selected as controls. At first, the knowledge, attitude and practice of women and health care providers during the past year were assessed as a baseline. All public and private health providers were re-educated for breast cancer early detection. The intervention was entitled 'Breast Month', three Breast Month's campaign during two years were planned. In each Breast month, eight 30 minutes TV programs were designed and broadcasted by local TV network and two SMS with short message on breast cancer awareness were sent to 170 000 customers (1.3 lines for each family). The study endpoints include the feasibility of using electronic media for breast cancer awareness and change in knowledge, attitude, and practice of women; breast tumor registration; patients' quality of life and their survival rate in both the case and control groups.Results:The women's knowledge about breast cancer was 67.86% and 71.08% of women had positive attitude to breast cancer early detection. During the control period, the average number of breast self examination (BSE) per woman was 4.68; but 47.6%have not done any BSE by themselves, and 79.50% did not referr to the physician for breast clinical examination and only 8.50% had undergone mammography. During the past year 42 new cases of breast cancer were diagnosed (14.67/105 crude incidence rate and 19.81/105 Age specified Incidence Rate).Conclusions:This study in its first phase has showed It is feasible to use electronic media and sms service in low to middle income countries for breast cancer awareness despite some cultural restrictions. Also there are low baseline level of BSE and very low baseline level of clinical eaxamination and mammography by Iranian women. Increased awareness has resulted in increase detection of breast cancer and the second phase is studying the effect on down staging as a result of increased awareness. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6074.