Analysis of Reasons for Referral and Coverage of Breast Cancer Screening of Women Who are Internally Displaced Persons: Data and Perspectives

Abstract

Millions of Ukrainian citizens were forced to leave their homes after the Russian invasion in Ukraine. Today the activation of social, humanitarian and medical problems is determined in Ukraine. A lot of internally displaced persons (IDPs) moved to the western regions, in particular, in Transcarpathia. Thousands of patients lost their family doctors and lost the permanent medical care. The main reasons for the doctor’s consultations are the treatment and primary care of the existing diseases. Screening and the early detection of cancer is not a priority and are ignored by the patients often. However, breast cancer (BC) remains the most common disease among female population in the country. In women 18–24 years old BC is in the third place in the disease structure (10.8%), in persons 30–74 years old its rate is 27.6–20.6 %. The objective: to perform the statistical analysis of the reasons for the referral to the doctor of the IDPs and to evaluate the frequency of the referrals for BC screening. Materials and methods. 2500 visits of IDPs to the doctors were registered in the clinic “InterFamily” (Uzhhorod). The reasons for the visits, diagnosis, medical management were coded with cods from the table “ICPC-2” in Excel program on the basis of which the research was conducted. Results. 657 women who are IDPs visited the doctor, 29.8% of them were 18–39 years old, 65% – 40–74 years old, 5.2% – over 75 years old. The patients were from all the regions of Ukraine that were affected by war direct invasion. The largest number of patients were from Donetsk, Luhansk regions, as well from Kharkiv, Zaporizhzhia and Kyiv regions. The most often reasons for the doctor’s visits were recorded respiratory diseases (23.8%), cardiovascular diseases (22.0%), diseases of the musculoskeletal system (9.5%), skin pathology, digestive organs and endocrine diseases (6.7%, 6.9% and 6.1%, respectively). Only 4.5% of all women 40–74 years old who were IDPs visited the volunteer clinic for BC screening, 0.5% of women 40–74 years old who were consulted for medical care not connected with female reproductive organs, or who visited clinic for prevention care, were referral for BC screening by a family doctor. Conclusions. BC screening had only 4.5% of women that indicate the low level of doctor’s concern and, probably, insufficient knowledge of women for diagnosis of this disease. A research project to study the motivation for BC screening of patients who are IDPs and the family doctors is proposed.