ArticleJCO global oncology2021
Barriers and Facilitators to Integrating Clinical Breast Examinations With Cervical Cancer Screening Programs in Outpatient Clinics in Western Kenya.
Article in JCO global oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- Early experience scaling up a breast cancer early detection initiative integrated with cervical cancer screening in Rwanda.BMJ global health · 2025Article
- Implementation and performance barriers in Iran's breast cancer screening program: a qualitative case study.Frontiers in public health · 2025Observational
- Integration of cervical cancer screening into healthcare facilities in low- and middle-income countries: A scoping review.PLOS global public health · 2024Article
- Baseline assessment of cervical cancer screening and treatment capacity in 25 counties in Kenya, 2022.Frontiers in oncology · 2024Article
- Patients' experiences undergoing breast evaluation in Rwanda's Women's Cancer Early Detection Program.Breast cancer research and treatment · 2023Article
- A qualitative study to explore healthcare providers' perspectives on barriers and enablers to early detection of breast and cervical cancers among women attending primary healthcare clinics in Johannesburg, South Africa.PLOS global public health · 2023Article
- Integrating Breast Cancer Early Detection Into a Resource-Constrained Primary Health Care System: Health Care Workers' Experiences in Rwanda.JCO global oncology · 2022Article
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
purposeNearly half of Kenyan women with breast cancer present with advanced disease-owing partially to limited patient education and screening limitations in low- and middle-income countries. With increasing access to nurse-led cervical cancer screening (CCS) in government clinics in Kenya, we investigated provider-perceived barriers and facilitators to integrating clinical breast examinations (CBEs) with ongoing CCS programs in Kisumu County, Kenya.
methodsCCS providers within the Ministry of Health Clinics in Kisumu County, Kenya, were recruited to participate in a two-phase, sequential, mixed methods study. Knowledge of CBE guidelines was assessed with a questionnaire. Providers with significant CCS and CBE experience then completed a one-on-one interview discussing barriers and facilitators to integration.
resultsSixty-nine providers from 20 randomly selected facilities participated in the survey. Providers all agreed that breast cancer screening was very important. Although 93% said that they routinely offered CBEs, only 22% of these providers screened at least eight of their last 10 patients. Forty-four percent identified four or more of five signs and symptoms of breast cancer, and 33% identified four to five risk factors. Although providers showed enthusiasm for integration of CBEs into their practices, barriers were identified and grouped into four themes: (1) fragmentation of services, (2) staffing shortage and inadequate on-the-job training, (3) limited space and referral system challenges, and (4) limited patient awareness on need for cancer screening.
conclusionAddressing providers' concerns by providing routine on-the-job clinical training, improving staffing shortages, strengthening the diagnostic and treatment referral pathway, and increasing patient education are some of the first steps in facilitating integration of CBEs with CCS services in primary care clinics in Kenya.
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