To conquer cervical and breast cancer in little charted waters: Synergistic and integrated approaches to identify early breast and cervical cancer in Cameroon.

Abstract

e17510 Background: Across Africa, several governments have put in place policies to promote prevention of cervical and breast cancers. (Njunguna 2020, Njiru 2013, WHO 2017) These include routine screening at consultations, sensitization programs, HPV vaccination programs, and creation of cancer treatment centers. However there still exists a policy to practice gap and clinicians do not routinely screen for cancers and sensitization messages are not reaching those who need it most. Therefore, on the one hand the clinicians are not supplying these services and the women who need the services are not demanding for them. Methods: We used existing guidance for cervical and breast cancer screening and treatment including local policies and ASCO guidelines. We screened 64 women in the Ntasen and Ntanka communities of Cameroon. We then used the results to create sensitization and education programmes for community members using culturally relevant approach of storytelling. Results: We reported 11 out of 64 positive cervical conditions (VIA pos = 8; VILI pos = 10; both VIA/VILI pos = 7) making a 17.2% prevalence. The median age for VIA/VILI positive was 35.5 years (Range 21-60 years). 3 out of 11 (27.3%) were HIV positive. We reported 4 out of 64 positive breast conditions (BIRADS 2 (2); BIRADS 3 (1); BIRADS 4 (1)). We reported 12 out of 64 STIs (gonorrhea (4); Syphilis (2); HPV (6)). Treatment could not be initiated for breast and cervical conditions due to lack of health technologies needed. Patients were therefore referred for treatment. All participants with gonorrhea and syphilis were immediately initiated treatment. Conclusions: Considering the high burden of disease from cervical and breast cancer in Cameroon, Africa, and LMIC, exploring cost effective approaches for screening like VIA/VILI will be helpful in reducing disease burden. However, access to low-cost health technologies to provide treatment for positive cases, use of culturally relevant approaches to sensitize communities to uptake these health technologies, inclusion of patient representatives in decision making, and capacity building for clinicians and community health workers for diagnosis and treatment are needed to complete the recipe for conquering cancers in LMIC. A combined approach of routinely screening for breast, cervical, and STIs is useful for integrating a common cause for these conditions.