World Journal of Surgery

, Volume 34, Issue 9, pp 2204–2210

Cost-Effectiveness of Clinical Breast Assessment-Based Screening in Rural Egypt

  • Adel Denewer
  • Osama Hussein
  • Omar Farouk
  • Waleed Elnahas
  • Ashraf Khater
  • Aiman El-Saed
Article

DOI: 10.1007/s00268-010-0620-3

Cite this article as:
Denewer, A., Hussein, O., Farouk, O. et al. World J Surg (2010) 34: 2204. doi:10.1007/s00268-010-0620-3

Abstract

Introduction

Breast cancer is the most common cancer in Egyptian women. However, the mean tumor size at diagnosis is 4.5 cm, and the median age is approximately 46 years. Both of these factors decrease the utility and cost-effectiveness of a mammography-based screening program typically designed for developed countries. We report the first clinical breast assessment-based screening project in an entirely rural Egyptian community.

Methods

Targeted population: Women aged 25–65 years in three municipal regions of Dakahlia province, Egypt. The estimated targeted population was 57,500 and participation was voluntary. First stage was performed at primary health care points. Surgeons performed systematic clinical breast examination. All data were collected at Mansoura University. Abnormal findings in the primary examination led to an invitation to the Oncology Center—Mansoura University—where the second stage of the study took place. It comprised repeat examination, ultrasonography, and/or mammography. Therapeutic interventions were performed at the governmentally funded Mansoura Oncology Center.

Results

Voluntary participation reached 10.2% of the target group and abnormal clinical examination represented 3.2% (191/5,900). The screen-detected cancers were (18/5,900) of examined population, and thus the cancer detection rate of clinical breast assessment-based screening was 30.5 per 100,000 of participating women during 2 years. The tumor size was 1.5 cm (median) and 1.3 cm (mean). The cost of screening per cancer case detected was approximately 415 US$, and the overall cost of treating a screen-detected cancer was 1,015–1,215 US$.

Conclusions

Clinical breast assessment-based screening with selective mammography is an effective modality, which improves the results of breast cancer management in Egypt.

Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Adel Denewer
    • 1
  • Osama Hussein
    • 1
  • Omar Farouk
    • 1
  • Waleed Elnahas
    • 1
  • Ashraf Khater
    • 1
  • Aiman El-Saed
    • 2
  1. 1.Surgical Oncology Department, Oncology Center Mansoura UniversityMansouraEgypt
  2. 2.Department of Epidemiology, Graduate School of Public Health University of PittsburghPittsburghUSA

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