Breaking Barriers in Cancer Screening: Understanding Participant Dropout in Breast and Cervical Programs in Morocco.

OBJECTIVE

This study aimed to investigate loss to follow-up (LFU) rates within breast and cervical cancer screening programs in Kenitra-Morocco, identifying contributing factors from both patient and healthcare worker perspectives to enhance care continuity.

METHODS

The study was a non-experimental, mixed-methods design conducted in three-phases. We started by identifying LFU women and their characteristics from medical records, interviewing LFU women to ascertain reasons for discontinuation, and surveying healthcare workers for perceived determinants of LFU through semi-structured questionnaires. The study covered primary healthcare centers, the Reproductive Health Reference Center (RCRH) in Kenitra, and the National Institute of Oncology (NIO) in Rabat.

RESULTS

Of 1,225 women studied, 94 cancer cases were diagnosed, with LFU rates varying across care stages. Key factors associated with LFU included age (p<0.005, OR=1.67, CI[1.2-2.4]), marital status (p<0.03, OR=0.8, CI[0.65-0.98]), distance from healthcare facilities (p<0.00, OR=2, CI[1.3-4.0]), and medical coverage (p<0.03, OR=2.3, CI[1.3-4.0]). Healthcare workers cited poor communication, organizational issues, and staffing shortages as barriers to follow-up.

CONCLUSIONS

The study underscores LFU's multifaceted reasons in Kenitra's cancer screening programs, suggesting improvements in communication after a positive screening test, re-engagement strategies, and financial accessibility. Addressing these issues is essential for reducing LFU rates, enhancing cancer care outcomes, and decreasing breast and cervical cancer mortality in Morocco.