Breast Cancer Screening in Morocco: Performance Indicators During Two Years of an Organized Programme

Background: Breast cancer is commonly diagnosed at late stages in countries with limited resources. InMorocco, breast cancer is ranked the first female cancer (36.1%) and screening methods could reduce theproportion presenting with a late diagnosis. Morocco is currently adopting a breast cancer screening programbased on clinical examination at primary health facilities, diagnosis at secondary level and treatment at tertiarylevel. So far, there is no systematic information on the performance of the screening program for breast cancerin Morocco. The aim of this study was to analyze early performance indicators. Materials and
Methods: Aretrospective evaluative study conducted in Temara city. The target population was the entire female populationaged between 45-70 years. The study was based on process and performance indicators collected at the individuallevel from the various health structures in Tamara between 2009 and 2011.
Results: A total of 2,350 womenparticipated in the screening program; the participation rate was 35.7%. Of these, 76.8% (1,806) were marriedand 5.2% (106) of this group had a family history of breast cancer. Of the women who attended screening, 9.3%(190) were found to have an abnormal physical examination findings. A total of 260 (12.7%) were referred fora specialist consultation. The positive predictive value of clinical breast examination versus mammographywas 23.0%. Forty four (35.5%) of the lesions found on the mammograms were classified as BI-RADs 3; 4 or 5category. Cancer was found in 4 (1.95%) of the total number of screened women and benign cases represented0.58%.
Conclusions: These first results of the programme are very encouraging, but there is a need to closelymonitor performance and to improve programme procedures with the aim of increasing both the participationrate and the proportion of women eligible to attend screening.