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Cancer Causes Control. 2016 Nov;27(11):1341-1345. Epub 2016 Sep 28.

Should low-income countries invest in breast cancer screening?

Author information

1
Department of Hemato-Oncology, Nobel Hospital, Sinamangal, Kathmandu, Nepal. bg.bishalgyawali@gmail.com.
2
Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan. bg.bishalgyawali@gmail.com.
3
Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan.

Abstract

With the increase in incidence and mortality of breast cancer in low-income countries (LICs), the question of whether LICs should promote breast cancer screening for early detection has gained tremendous importance. Because LICs have limited financial resources, the value of screening must be carefully considered before integrating screening programs into national healthcare system. Mammography-the most commonly used screening tool in developed countries-reduces breast cancer-specific mortality among women of age group 50-69, but the evidence is not so clear for younger women. Further, it does not reduce the overall mortality. Because the women in LICs tend to get breast cancer at younger age and are faced with various competing causes of mortality, LICs need to seriously evaluate whether mammographic screening presents a good value for the investment. Instead, we suggest a special module of clinical breast examination that could provide similar benefits at a very low cost. Nevertheless, we believe that LICs would obtain a much greater value for their investment if they promote primary prevention by tobacco cessation, healthier food and healthier lifestyle campaigns instead.

KEYWORDS:

Breast cancer; Clinical breast examination; Cost-effectiveness; Mammography; Screening

PMID:
27680017
DOI:
10.1007/s10552-016-0812-8
[Indexed for MEDLINE]

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