PURPOSE Breast cancer early detection in Ukraine and other low and middle-income countries (LMICs) often includes opportunistic screening. Evaluation of factors that affect screening is key to improving early detection. METHODS An online survey for primary care physicians (PCPs) was distributed through PCP-focused social media in Ukraine. Data were analyzed using descriptive statistics. RESULTS 435 PCPs from all regions of Ukraine completed the survey, including 389 (89.4%) women, 375 (86.2%) family medicine, 60 (13.8%) internal medicine physicians. 349 (80.2%) referred women for screening mammography. 252 (57.9%) conducted screening clinical breast exams (CBE), while 135 (31.0%) referred patients to mammalogists or 133 (30.6%) to gynecologists for CBE. Within one's practice, mammography was available for 81 (18.6%), mammalogists for 39 (9.0%), and gynecologists for 133 (30.3%). Breast cancer screening was prompted by MOH Order 504 for 281 (64%), family history 266 (61%), patient pathway guidelines 94 (21.6%), availability of subspecialists 78 (17.9%), and patient request 132 (30%). Reasons for not conducting CBE screening included insufficient experience 88 (20.2%), patients declining CBE 63 (14.5%), lack of time 59 (13.6%). Reasons for not conducting mammography screening included patients declining (11.7%) and absence of mammography (6.4%).). 350 (80.5%) were familiar with the Ministry of Health (MOH) Order 504, which describes eligibility criteria for breast cancer screening, and 291 (66.9%) used it to guide their screening practice. Others used US or European recommendations (62 (14.3%) and 115 (26.4%), respectively), and institution-specific patient pathways 117 (26.9%). Barriers to breast cancer screening included insufficient PCP training (53%) and experience (40%) and insufficient mammography availability (33%). Strategies for increasing breast cancer screening included improving collaboration between PCPs and oncologists 175 (40.2%), educational materials for patients 169 (38.9%), PCP education/training 168 (38.6%), automatic electronic health record reminders 150 (34.5%). CONCLUSION We identified important barriers and facilitators of breast cancer screening from the point of view of PCPs in Ukraine. Our results were limited by online convenience sampling.
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