Effectiveness of breast cancer screening campaigns from 2012 to 2017 by analysis of stage at diagnosis, Lebanon

Abstract

Background: Breast cancer is the most common and costly disease in Lebanon, but data on cancer stage and mortality are scarce. Aims: This study aimed to assess the effect of mammography screening campaigns in reducing the breast cancer stage at diagnosis. Methods: A secondary analysis was conducted of data from the Ministry of Public Health’s Cancer Drug Scientific Committee database. The medical files of 3320 newly diagnosed breast cancer patients between 2012 and 2017 were reviewed. Demographic and pathology characteristics, cancer stage at diagnosis and presence of receptors were extracted and analysed. Results: The median age of the patients was 53 (interquartile range 36–72) years. Most patients had positive estrogen and progesterone receptors. Patients < 35 years mostly lived in South Lebanon, had advanced stages of cancer (III and IV) at diagnosis and were more likely to have triple negative breast cancer than the older groups (31.3% versus 16.7%). Advanced stage at diagnosis was common outside Beirut (60.4% in Bekaa and 54.7% in North Lebanon). In the period 2012–2017, the trend in early stages (I and II) at diagnosis decreased from 55.6% to 41.9%, while advanced stages (III and IV) increased from 44.4% to 57.9%. Conclusion: Efforts to downstage breast cancer through mammography screening in Lebanon have not succeeded. Implementation of genetic testing and tailored approaches for Lebanese women are recommended for future campaigns.