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加纳的乳腺 X 光摄影术和乳腺超声服务:可及性和地理可及性。

Mammography and Breast Ultrasonography Services in Ghana, Availability, and Geographic Access.

机构信息

Center for Global Surgery, The University of Utah, Salt Lake City, UT.

Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.

出版信息

JCO Glob Oncol. 2024 Aug;10:e2400218. doi: 10.1200/GO.24.00218.

Abstract

PURPOSE

Breast cancer is the leading type of cancer diagnosed and the second leading cause of cancer-related death in Ghana. Mammography and ultrasound have proven benefits in the early detection of breast cancer. This study evaluates mammography, breast ultrasound, and radiology work force availability throughout Ghana.

METHODS

A survey was administered to all hospitals in Ghana from November 2020 to October 2021. Mammography, breast ultrasound services, and the number of radiologists were assessed. For mammography, the number performed per month, cost incurred by the patient, where images were read, and how long it took to receive reports were also assessed. Health Facilities Regulatory Authority records on diagnostic centers were obtained to identify additional in-country breast imaging services.

RESULTS

Three hundred and twenty-eight of 346 hospitals participated in the survey (95%). Only 21 hospitals reported on-site mammography. One hospital reported performing >100 mammographies per month. The average cost to the patient ranged from 100 to 500 Cedis ($17-87 US dollars [USD]), although three hospitals performed mammography at no cost. An additional 10 mammography machines were identified at diagnostic centers throughout the country, with 41.3% of the female population living within 1 hour of mammography services. There were 135 hospital-based breast ultrasound services identified with 69.5% of the female population living within 1 hour of these services. There were an additional 190 ultrasound machines at diagnostic centers. There were 96 in-country radiologists identified.

CONCLUSION

Although there is limited availability and utilization of mammography in Ghana, there is more readily available ultrasonography. A focus on increasing breast cancer early diagnostic capabilities with breast ultrasound should be prioritized in addition to further expansion of the radiology workforce.

摘要

目的

乳腺癌是加纳诊断出的主要癌症类型,也是癌症相关死亡的第二大主要原因。乳房 X 光摄影和超声检查已被证明可有效用于早期发现乳腺癌。本研究评估了加纳各地的乳房 X 光摄影、乳房超声检查以及放射科工作人员的可用性。

方法

我们于 2020 年 11 月至 2021 年 10 月向加纳的所有医院发放了一份调查问卷,评估了乳房 X 光摄影、乳房超声服务以及放射科医生的数量。对于乳房 X 光摄影,我们评估了每月进行的检查次数、患者承担的费用、阅片地点以及获得报告所需的时间。我们还从卫生设施监管局获得了关于诊断中心的记录,以确定加纳国内其他的乳房成像服务。

结果

346 家医院中有 328 家(95%)参与了调查。仅有 21 家医院报告提供现场乳房 X 光摄影服务。一家医院报告每月进行的乳房 X 光摄影检查次数超过 100 次。患者的平均费用在 100 至 500 塞地(17-87 美元)之间,尽管有 3 家医院提供免费的乳房 X 光摄影服务。在全国各地的诊断中心还发现了另外 10 台乳房 X 光摄影机,有 41.3%的女性居住在距离乳房 X 光摄影服务 1 小时车程范围内。有 135 家医院提供基于医院的乳房超声服务,有 69.5%的女性居住在距离这些服务 1 小时车程范围内。在诊断中心还有另外 190 台超声机。在加纳国内有 96 名放射科医生。

结论

尽管加纳的乳房 X 光摄影服务的可用性和利用率有限,但超声检查的可及性更高。除了进一步扩大放射科工作人员队伍外,还应优先考虑增加乳房超声检查以提高乳腺癌早期诊断能力。

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Global guidelines for breast cancer screening: A systematic review.全球乳腺癌筛查指南:系统评价。
Breast. 2022 Aug;64:85-99. doi: 10.1016/j.breast.2022.04.003. Epub 2022 Apr 19.

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