Evidence map›Paper›PMID 37646967›Full record

ArticleBreast cancer research and treatment2023

Patients' experiences undergoing breast evaluation in Rwanda's Women's Cancer Early Detection Program.

Lydia E Pace, Amanda M Fata, Vincent K Cubaka, Theophile Nsemgiyumva, Jean de Dieu Uwihaye, Catherine Stauber, Jean-Marie Vianney Dusengimana, Kayleigh Bhangdia, Lawrence N Shulman, Anna Revette and 3 more

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Article in Breast cancer research and treatment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Lydia E PaceBrigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. lpace@bwh.harvard.edu.ORCID http://orcid.org/0000-0002-5378-0296
Amanda M FataBrigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Vincent K CubakaPartners In Health, Kigali, Rwanda.
Theophile NsemgiyumvaUSAID Rwanda Integrated Health System Activity, Kigali, Rwanda.
Jean de Dieu UwihayePartners In Health, Kigali, Rwanda.
Catherine StauberDell Medical School, University of Texas, Austin, TX, USA.
Jean-Marie Vianney DusengimanaPartners In Health, Kigali, Rwanda.
Kayleigh BhangdiaInstitute for Health Metrics and Evaluation, Seattle, WA, USA.
Lawrence N ShulmanAbramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
Anna RevetteDana-Farber Cancer Institute, Boston, MA, USA.
Marc HagenimanaRwanda Biomedical Centre, Kigali, Rwanda.
Francois UwinkindiRwanda Biomedical Centre, Kigali, Rwanda.
Enock RwamuzaPalladium Group, Kigali, Rwanda.

Funding

Evaluating breast cancer care in rural RwandaK07CA215819 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI PACE, LYDIA · 2018 to 2023
$1.0M
NCI NIH HHS K07 CA215819NIH HHS 1K07CA215819-01A1
6 · The paper itself

Abstract

purposeThere is urgent need for interventions to facilitate earlier diagnosis of breast cancer in low- and middle-income countries where mammography screening is not widely available. Understanding patients' experiences with early detection efforts, whether they are ultimately diagnosed with cancer or benign disease, is critical to optimize interventions and maximize community engagement. We sought to understand the experiences of patients undergoing breast evaluation in Rwanda's Women's Cancer Early Detection Program (WCEDP).

methodsWe conducted in-person semi-structured interviews with 30 patients in two districts of Rwanda participating in the WCEDP. Patients represented a range of ages and both benign and malignant diagnoses. Interviews were recorded, transcribed, translated, and thematically analyzed.

resultsParticipants identified facilitators and barriers of timely care along the breast evaluation pathway. Community awareness initiatives were facilitators to care-seeking, while persistent myths and stigma about cancer were barriers. Participants valued clear clinician-patient communication and emotional support from clinicians and peers. Poverty was a major barrier for participants who described difficulty paying for transport, insurance premiums, and other direct and indirect costs of hospital referrals in particular. COVID-19 lockdowns caused delays for referred patients. Although false-positive clinical breast exams conferred financial and emotional burdens, participants nonetheless voiced appreciation for their experience and felt empowered to monitor their own breast health and share knowledge with others.

conclusionRwandan women experienced both benefits and burdens as they underwent breast evaluation. Enthusiasm for participation was not reduced by the experience of a false-positive result. Reducing financial, logistical and emotional burdens of the breast diagnostic pathway through patient navigation, peer support and decentralization of diagnostic services could improve patients' experience.

Indexed as

Breast NeoplasmsEarly Detection of CancerAdultAgedCOVID-19FemaleHumansMammographyMiddle AgedPatient Acceptance of Health CareRwandaSARS-CoV-2Social StigmaBreast neoplasmsEarly detection of cancerHealth expendituresPatient satisfactionRwanda

Identifiers

PMID37646967
PMCPMC11670140

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.