Women cancer early detection and linkage to care (navigation) in Rwandan community.

Abstract

e18740 Background: Whilst early detection and treatment of breast and cervical cancers are increasing, a large number of cancer patients in low and middle income countries lack access to prompt, high-quality diagnosis and care.This study’s primary objective was to demonstrate real time prevalence of breast and cervical cancer from Rwandan district community and establish a link to care for timely diagnosis and treatment in order to curb the health system delays. Methods: From June 2022 January 2023, the Women's Cancer Early Detection Program (WCED) was initiated in Kicukiro district health facilities. The community health workers were Identified, training was given, centers were chosen for integrated screening then clinical breast exams /ultrasound for suspected lesions and cervical cancer screening ((HPV DNA /VIA) done. Precancerous lesions treated by thermal ablation in the community. Patient suspected for cancer were navigated to Rwanda military hospital for biopsy and treatment. Results: A total number of 4,991 were screened. 372 with abnormal findings on clinical breast exam then through ultrasound, 16 women were selected for biopsies. From the highly suspected, 13 (0.3%) confirmed positive for breast cancer. All confirmed cancer cases were staged according to AJCC 8th edition (TNM) at Rwanda cancer center. TNM staging revealed that 7 (54%) women out of those 13 were of T1-T2N0M0(early stage).They were sent to the multidisciplinary team for treatment planning and treatment with curative intent initiated. Conclusions: Rwanda biomedical center indicates that 65% of our patients arrive at treatment centers with T3-T4N1-3M0-1 (locally advanced and metastatic). The above data shows that through the integrated navigation program, there is a shift from presentation t late stage to early stage. This model is simple and easy for low and middle income countries because it ensures a proper referral process, efficient delivery of optimal care, and patient support to overcome challenges mainly due to health system delay.