Kurian Neetha Mary, Boby Jeffrey Mathew, Suneesh Somannair, Datta Sumit, Mathew Aju
MOSC Medical College, Kolenchery 682311, Kerala, India.
Ecancermedicalscience. 2023 Nov 21;17:1637. doi: 10.3332/ecancer.2023.1637. eCollection 2023.
Breast cancer incidence rates in India are rising. The majority of breast cancers are still diagnosed in later stages. There is also a burden of neglected cancers in India, where patients neglect their symptoms due to fear, ignorance, financial insecurity and lack of access to medical care. This results in greater morbidity and mortality from breast cancer. Systematic screening programs have been tested in an Indian setting, with limited success. An effective strategy to downstage breast cancer is an area of unmet need. We aimed to explore the effectiveness of an anonymous nurse-led telephone helpline in identifying patients with possible breast malignancies and to encourage them to seek healthcare. We created a telephone helpline system by training junior public health nurses (JPHNs) to provide counselling to women who may call with breast-related symptoms. We then created a short video message on the initiative and disseminated it using social media platforms. During the 1-year study period, 434 calls were received from individuals who reported having some breast symptoms. Among them, 28% (122 callers) had never consulted a doctor for their symptoms. 78 callers consulted a nearby doctor upon the advice of the JPHN. Among them, 14 callers (18%) were advised by the doctor to undergo investigations to rule out malignancy, while 64 (82%) of them were found to have some benign/normal breast conditions. 3 (21%) out of the 14 patients who underwent further evaluation were eventually diagnosed with breast cancer. Our study provides evidence that an anonymous nurse-led telephone helpline can be an effective strategy to reduce the incidence of neglected breast cancers and downstage the diagnoses.
印度乳腺癌发病率呈上升趋势。大多数乳腺癌仍在晚期才被诊断出来。印度还存在被忽视癌症的负担，患者因恐惧、无知、经济不安全和难以获得医疗服务而忽视自身症状。这导致乳腺癌的发病率和死亡率更高。系统的筛查项目已在印度进行了测试，但成效有限。降低乳腺癌分期的有效策略是一个尚未满足的需求领域。我们旨在探索由护士主导的匿名电话热线在识别可能患有乳腺恶性肿瘤的患者并鼓励他们寻求医疗保健方面的有效性。我们通过培训初级公共卫生护士（JPHNs）来创建一个电话热线系统，以便为可能因乳腺相关症状来电的女性提供咨询。然后，我们就该倡议制作了一条短视频信息，并通过社交媒体平台进行传播。在为期1年的研究期间，我们接到了434个自称有一些乳腺症状的个人打来的电话。其中，28%（122名来电者）从未就其症状咨询过医生。78名来电者根据初级公共卫生护士的建议咨询了附近的医生。其中，14名来电者（18%）被医生建议进行检查以排除恶性肿瘤，而其中64名（82%）被发现患有一些良性/正常乳腺疾病。在接受进一步评估的14名患者中，有3名（21%）最终被诊断出患有乳腺癌。我们的研究表明，由护士主导的匿名电话热线可以成为减少被忽视乳腺癌发病率和降低诊断分期的有效策略。
