Médecine communautaire et éducation à la santé

Abstrait

Screening Mammography Outcomes in One Community-Based Initiative in Lebanon

Sidaoui JA, Lotfi TM and Adib SM

Introduction and objectives: The outcomes of a screening mammography initiative implemented by a Lebanese NGO over several years are analyzed to assess 1. the socio-demographic and reproductive characteristics associated with repeating a screening mammography after receiving reassuring results from a first one, and 2, to estimate the proportion of suspicious mammograms resulting from a mass screening activity.
Methods: A total of 2885 women participated in the screening initiative between 1997 and 2013, during which they were able to obtain repeated annual mammograms free of charge.
Results: A steady significant decrease in mean age at first mammography was found from 2002 (59.1 years) to 2013 (48.4 years). Given enough time span, 44% repeated the test at least once after receiving reassuring results. Factors associated with test repetition were older age and retired employment status. Mammography results were suspicious (ACR4 or 5) in 2.3% of cases.
Discussion and conclusions: The proportion of suspicious mammography results is close to those reported from countries with similar incidence rates of breast cancer. This suggests that mammography quality in Lebanon is acceptable globally, although gaps may be detected for specific centers. The percentage of annual test repetition (44%) was much lower than in other developing (Brazil: 90%) or developed countries (USA: 82%), even when financial barriers were cancelled. Among non-retired women, household worries and/or professional activities may be competing with self-care, compared to retired women. Mammography centers should be encouraged to adopt flexible opening hours to facilitate the access to working women.