Evidence map›Paper›PMID 38730486›Full record

ArticleBMC health services research2024

Implementation of a clinical breast exam and referral program in a rural district of Pakistan.

Russell Seth Martins, Aiman Arif, Sahar Yameen, Shanila Noordin, Taleaa Masroor, Shah Muhammad, Mukhtiar Channa, Sajid Bashir Soofi, Abida K Sattar

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

9 authors.

Russell Seth Martins *Division of Thoracic Surgery, Department of Surgery, Hackensack Meridian School of Medicine, Hackensack Meridian Health Network, Nutley, NJ, 08820, USA.
Aiman Arif *Aga Khan University, Karachi, 74800, Pakistan.
Sahar Yameen *Aga Khan University, Karachi, 74800, Pakistan.
Shanila Noordin *Aga Khan University, Karachi, 74800, Pakistan.
Taleaa MasroorDepartment of Surgery, John Hopkins University, Baltimore, MD, 21218, USA.
Shah MuhammadAga Khan University, Karachi, 74800, Pakistan.
Mukhtiar ChannaAga Khan University, Karachi, 74800, Pakistan.
Sajid Bashir SoofiAga Khan University, Karachi, 74800, Pakistan.
Abida K SattarAga Khan University, Karachi, 74800, Pakistan. abida.sattar@aku.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of clinical breast examination (CBE) for early detection of breast cancer is extremely important in lower-middle-income countries (LMICs) where access to breast imaging is limited. Our study aimed to describe the outcomes of a community outreach breast education, home CBE and referral program for early recognition of breast abnormalities and improvement of breast cancer awareness in a rural district of Pakistan.

methodsEight health care workers (HCW) and a gynecologist were educated on basic breast cancer knowledge and trained to create breast cancer awareness and conduct CBE in the community. They were then deployed in the Dadu district of Pakistan where they carried out home visits to perform CBE in the community. Breast cancer awareness was assessed in the community using a standardized questionnaire and standard educational intervention was performed. Clinically detectable breast lesions were identified during home CBE and women were referred to the study gynecologist to confirm the presence of clinical abnormalities. Those confirmed to have clinical abnormalities were referred for imaging. Follow-up home visits were carried out to assess reasons for non-compliance in patients who did not follow-through with the gynecologist appointment or prescribed imaging and re-enforce the need for follow-up.

resultsBasic breast cancer knowledge of HCWs and study gynecologist improved post-intervention. HCWs conducted home CBE in 8757 women. Of these, 149 were warranted a CBE by a physician (to avoid missing an abnormality), while 20 were found to have a definitive lump by HCWs, all were referred to the study gynecologist (CBE checkpoint). Only 50% (10/20) of those with a suspected lump complied with the referral to the gynecologist, where 90% concordance was found between their CBEs. Follow-up home visits were conducted in 119/169 non-compliant patients. Major reasons for non-compliance were a lack of understanding of the risks and financial constraints. A significant improvement was observed in the community's breast cancer knowledge at the follow-up visits using the standardized post-test.

conclusionsBasic and focused education of HCWs can increase their knowledge and dispel myths. Hand-on structured training can enable HCWs to perform CBE. Community awareness is essential for patient compliance and for early-detection, diagnosis, and treatment.

Indexed as

Breast NeoplasmsEarly Detection of CancerReferral and ConsultationRural PopulationAdultFemaleHealth Knowledge, Attitudes, PracticeHumansMiddle AgedPakistanPhysical ExaminationSurveys and QuestionnairesBreast cancerClinical breast examCommunity outreach programHealthcare workers

Identifiers

PMID38730486
PMCPMC11083956

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LicenceCC BY
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Registered trials

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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.