Alfaisal University, College of Medicine, Riyadh, Saudi Arabia.
Department of Clinical Research, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Asian Pac J Cancer Prev. 2023 Mar 1;24(3):923-927. doi: 10.31557/APJCP.2023.24.3.923.
Breast cancer is ranked as the most common type of cancer effecting women worldwide. Early detection is associated with improved morbidity and mortality, along with decreased recurrence rates, due to regular breast cancer screening recommendations advised for women over the age of 40. Women in the Kingdom of Saudi Arabia (KSA) typically present with advanced symptoms at later stages due to lower-than-average rates of breast cancer awareness and screening.
A case-control study was conducted utilizing data collected over 20 years in the primary care clinics linked to at a tertiary hospital to demonstrate the role of structured breast cancer screening programs within well-established primary care setting. Results were compared with outcomes of cancer cases diagnosed in the community through opportunistic diagnosis.
A total 292 patients included in the study had an overall mean survival time of 160 months, with a statistically significant higher survival time noted amongst the primary care group of 49 patients (p<0.01) by approximately 85 months. Clinical stages and clinical response rates between the two patient groups were found to be statistically significant (p<0.01), where 35 (73.3%) primary care patients were stage IIA and below, compared to 41 (30%) oncology patients. Patients who were diagnosed with breast cancer in the primary care group with well-established breast cancer screening programs were noted to present with breast cancer at earlier stages, have better prognosis and lower mortality as opposed to the oncology patient group.
Our study highlights the need of structured breast cancer screening programs within well supported primary health services in Saudi Arabia and the region. Such programs were associated with improved survival outcomes and more favorable clinical responses. There is an urgent need to enable primary care services with the appropriate resources to significantly impact patient morbidity and mortality.
乳腺癌是全球女性最常见的癌症类型。早期检测与改善发病率和死亡率相关，同时降低复发率，这是因为建议 40 岁以上的女性定期进行乳腺癌筛查。由于沙特阿拉伯王国（KSA）女性对乳腺癌的认识和筛查率较低，她们通常在晚期出现晚期症状。
利用在一家三级医院相关的初级保健诊所收集了超过 20 年的数据进行病例对照研究，以展示在成熟的初级保健环境中实施结构化乳腺癌筛查计划的作用。结果与通过机会性诊断在社区中诊断出的癌症病例的结果进行了比较。
研究共纳入 292 例患者，总平均生存时间为 160 个月，初级保健组 49 例患者的总体生存时间明显更长（p<0.01），约长 85 个月。两组患者的临床分期和临床反应率存在统计学差异（p<0.01），其中 35 例（73.3%）初级保健患者为 IIA 期及以下，而肿瘤学患者为 41 例（30%）。在建立了乳腺癌筛查计划的初级保健组中诊断出乳腺癌的患者，其表现出的乳腺癌分期更早，预后更好，死亡率更低，而肿瘤学患者组则相反。
我们的研究强调了在沙特阿拉伯和该地区的基层卫生服务中建立结构化乳腺癌筛查计划的必要性。这些计划与改善生存结果和更有利的临床反应相关。迫切需要为初级保健服务提供适当的资源，以显著影响患者的发病率和死亡率。
