Assessing Pakistan’s Readiness for a National Mammography Screening Guideline Five Years After Intervention

1Dr Haroon ur Rashid, 2Muhammad Usman, 3Umar Shah, 3Akhtar Javed, 3Haroon Marwat, 3Tahmoor Ghori

1Assistant professor, Department of Radiotherapy & Nuclear Medicine Dr Faisal Masood Teaching Hospital Sargodha.

2Senior registrar, Rai medical college teaching hospital

2UHS Lahore

Abstract:

Cancer, notably breast cancer, is a significant health concern globally, with a substantial burden in Asia, particularly in Pakistan. Late diagnosis exacerbates mortality rates, emphasizing the importance of robust screening programs. This article examines the effectiveness of breast cancer screening initiatives and interventions five years after an initial pilot study that spanned from 2015-2019, exploring trends in screening activity from 2020 to 2024, along with the use of current health guidelines and studies, and using data from the Islamabad Federal Breast Cancer Screening Centre to assess readiness for national guideline implementation in Pakistan and beyond.

Methods: This retrospective cross-sectional study, conducted at the Federal Breast Cancer Screening Center

(FBCSC), involved 7,454 patients undergoing mammography screening over a five-year period from 2020 to 2024. The study examined patients’ data, including Breast Imaging Reporting and Data System (BIRADS) categories through double reading mammography and complementary ultrasound (USG) findings. Demographic information, including age, ethnicity, education status, socio-economic factors, breastfeeding history, breast density, and family history, was recorded to analyze its correlation with breast cancer diagnosis and subsequent management. Data analysis was performed using SPSS 2023.

Results: The study included a total of 7,454 patients who visited the Federal Breast Cancer Screening Centre from 2020 to 2024. The mean age of patients attending screenings from 2020 to 2023 was 48.7 ± 9.50 years, with the most common age group being 41-45 years 1,364 (24.4%), followed by 41-45 years 1,939 (26.0%). The ethnicity with the highest frequency was Punjabi 5,883 (78.9 %). The distribution of patients across

BIRADS categories was as follows: BIRADS 0 (n=216, 2.90%), BIRADS I (n=2,538, 34.0%), BIRADS II

(n=2,375, 31.90%), BIRADS III (n=799, 10.70%), BIRADS IV (n=832, 11.20%), BIRADS V (n=526, 7.10%), and BIRADS VI (n=168, 2.30%). The prevalence rate of invasive breast cancer during these four years was 10.4%.

Conclusion: This study found a significant rise in patient visits to the Federal Breast Cancer Screening Clinic from 2020 to 2024. Key predictors of breast cancer included age, marital status, breastfeeding history, socioeconomic status, and family history. No significant links were found with ethnicity or education. These findings underscore the importance of ongoing research to improve breast cancer screening programs in Pakistan, and highlight the importance of collaboration between healthcare providers and policymakers for improved health outcomes.

Keywords: breast cancer; screening mammography; cancer prevention; healthcare