- Volume 16 Issue 17
DOI QR Code
Feasibility Study of Case-Finding for Breast Cancer by Community Health Workers in Rural Bangladesh
- Chowdhury, Touhidul Imran (Amader Gram Cancer Care and Research Center) ;
- Love, Richard Reed (Amader Gram Cancer Care and Research Center) ;
- Chowdhury, Mohammad Touhidul Imran (Amader Gram Cancer Care and Research Center) ;
- Artif, Abu Saeem (Amader Gram Cancer Care and Research Center) ;
- Ahsan, Hasib (Amader Gram Cancer Care and Research Center) ;
- Mamun, Anwarul (Amader Gram Cancer Care and Research Center) ;
- Khanam, Tahmina (Amader Gram Cancer Care and Research Center) ;
- Woods, James (Amader Gram Cancer Care and Research Center) ;
- Salim, Reza (Amader Gram Cancer Care and Research Center)
- Published : 2015.12.03
Background: Mortality from breast cancer is high in low- and middle-income countries, in part because most patients have advanced stage disease when first diagnosed. Case-finding may be one approach to changing this situation. Materials and Methods: We conducted a pilot study to explore the feasibility of population-based case finding for breast cancer by community health workers (CHWs) using different data collection methods and approaches to management of women found to have breast abnormalities. After training 8 CHWs in breast problem recognition, manual paper data collection and operation of a cell-phone software platform for reporting demographic, history and physical finding information, these CHWs visited 3150 women >age 18 and over they could find-- from 2356 households in 8 villages in rural Bangladesh. By 4 random assignments of villages, data were collected manually (Group 1), or with the cell-phone program alone (Group 2) or with management algorithms (Groups 3 and 4), and women adjudged to have a serious breast problem were shown a motivational video (Group 3), or navigated/accompanied to a breast problem center for evaluation (Group 4). Results: Only three visited women refused evaluation. The manual data acquisition group (1) had missing data in 80% of cases, and took an average of 5 minutes longer to acquire, versus no missing data in the cell phone-reporting groups (2,3 and 4). One woman was identified with stage III breast cancer, and was appropriately treated. Conclusions: Among very poor rural Bangladeshi women, there was very limited reluctance to undergo breast evaluation. The estimated rarity of clinical breast cancer is supported by these population-based findings. The feasibility and efficient use of mobile technology in this setting is supported. Successor studies may most appropriately be trials focusing on improving the suggested benefits of motivation and navigation, on increasing the numbers of cases found, and on stage of disease at diagnosis as the primary endpoint.
- Alwan A, Armstrong T, Cowan C, et al (2011). Noncommunicable diseases country profiles. World Health Organization. Retrieved January 03, 2012, from http:// whqlibdoc.who.int/publications/2011/9789241502283_eng.pdf
- DeRenzi B, Borriello G., Jackson J, et al (2011). Mobile Phone Tools for Field-Based Health care Workers in Low-Income Countries. Mount Sinai J Med, 78, 406-18 https://doi.org/10.1002/msj.20256
- Economist Intelligence Unit, Breakaway (2009). The global burden of cancer-challenges and opportunities. The Economist.
- Formenti SC, Arslan AA, Love SM, (2012). Global breast cancer: the lessons to bring home. Int J Breast Cancer.
- Ghose S. (2010). The use of mobile (Cellular) oral telemedicine in botswana. Mobile Communication Technol Development (M4D), 336-7.
- Malik I A (2002). Clinico-pathological features of breast cancer in Pakistan. J Pakistan Med Assoc, 53, 100-4.
- Mathers C D, Loncar D, (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med, 3, 442. https://doi.org/10.1371/journal.pmed.0030442
- McWilliams J, (2010). Connecting cell phones with medicine in Botswana. Penn Current. Retrieved November 25, 2011, from http://www.upenn.edu/pennnews/current/node/3215
- mHealth for Development (2010). The Opportunity of Mobile Technology for Healthcare in the Developing World. United Nations Foundation & Vodafone Foundation.
- Omar S, Kahled H, Gaafar R, et al (2003). Breast cancer in Egypt: A review of disease presentation and detection strategies. East Med Health J, 9, 448-63
- Schwartzmann G, (2001). Breast Cancer in South Africa: Challenges to improve early detection and medical management of a public health problem. J Clin Oncol, 19, 118-24.
- Sen U, Sankaranarayanan R, Mandal S, et al (2002). Cancer patterns in Eastern India: the first report of the Kolkata Cancer Registry, Int J Cancer 100: 86-91. https://doi.org/10.1002/ijc.10446
- Story H L, Love R R, Salim R, et al (2012). Improving outcomes from breast cancer in a low-income country: lessons from Bangladesh. Int J Breast Cancer.