PDF(Pubmed)
Abstract：
Breast cancer is ranked as the most common type of cancer effecting women worldwide. Early detection is associated with improved morbidity and mortality, along with decreased recurrence rates, due to regular breast cancer screening recommendations advised for women over the age of 40. Women in the Kingdom of Saudi Arabia (KSA) typically present with advanced symptoms at later stages due to lower-than-average rates of breast cancer awareness and screening.
A case-control study was conducted utilizing data collected over 20 years in the primary care clinics linked to at a tertiary hospital to demonstrate the role of structured breast cancer screening programs within well-established primary care setting. Results were compared with outcomes of cancer cases diagnosed in the community through opportunistic diagnosis.
A total 292 patients included in the study had an overall mean survival time of 160 months, with a statistically significant higher survival time noted amongst the primary care group of 49 patients (p<0.01) by approximately 85 months. Clinical stages and clinical response rates between the two patient groups were found to be statistically significant (p<0.01), where 35 (73.3%) primary care patients were stage IIA and below, compared to 41 (30%) oncology patients. Patients who were diagnosed with breast cancer in the primary care group with well-established breast cancer screening programs were noted to present with breast cancer at earlier stages, have better prognosis and lower mortality as opposed to the oncology patient group.
Our study highlights the need of structured breast cancer screening programs within well supported primary health services in Saudi Arabia and the region. Such programs were associated with improved survival outcomes and more favorable clinical responses. There is an urgent need to enable primary care services with the appropriate resources to significantly impact patient morbidity and mortality.
A case-control study was conducted utilizing data collected over 20 years in the primary care clinics linked to at a tertiary hospital to demonstrate the role of structured breast cancer screening programs within well-established primary care setting. Results were compared with outcomes of cancer cases diagnosed in the community through opportunistic diagnosis.
A total 292 patients included in the study had an overall mean survival time of 160 months, with a statistically significant higher survival time noted amongst the primary care group of 49 patients (p<0.01) by approximately 85 months. Clinical stages and clinical response rates between the two patient groups were found to be statistically significant (p<0.01), where 35 (73.3%) primary care patients were stage IIA and below, compared to 41 (30%) oncology patients. Patients who were diagnosed with breast cancer in the primary care group with well-established breast cancer screening programs were noted to present with breast cancer at earlier stages, have better prognosis and lower mortality as opposed to the oncology patient group.
Our study highlights the need of structured breast cancer screening programs within well supported primary health services in Saudi Arabia and the region. Such programs were associated with improved survival outcomes and more favorable clinical responses. There is an urgent need to enable primary care services with the appropriate resources to significantly impact patient morbidity and mortality.
摘要：
乳腺癌被列为影响全世界妇女的最常见的癌症类型。早期发现与发病率和死亡率的提高有关，随着复发率的下降，由于定期乳腺癌筛查建议40岁以上的女性。沙特阿拉伯王国（KSA）的女性通常在晚期阶段出现晚期症状，因为乳腺癌的认知率和筛查率低于平均水平。
一项病例对照研究利用20多年来在与三级医院相关的初级保健诊所收集的数据进行，以证明结构化乳腺癌筛查计划在完善的初级保健环境中的作用。将结果与通过机会性诊断在社区中诊断出的癌症病例的结果进行比较。
纳入研究的292例患者的总体平均生存时间为160个月。在49例患者（p<0.01）的初级保健组中，有统计学意义的存活时间延长了约85个月。发现两组患者之间的临床分期和临床反应率具有统计学意义（p<0.01），其中35名(73.3%)初级保健患者为IIA期及以下，与41（30％）肿瘤患者相比。在初级保健组中被诊断出患有乳腺癌的患者在建立完善的乳腺癌筛查计划中被注意到在早期阶段出现乳腺癌。与肿瘤患者组相比，预后更好，死亡率更低。
我们的研究强调了在沙特阿拉伯和该地区得到良好支持的初级卫生服务中需要结构化的乳腺癌筛查计划。这些方案与改善的生存结果和更有利的临床反应相关。迫切需要以适当的资源提供初级保健服务，以极大地影响患者的发病率和死亡率。
一项病例对照研究利用20多年来在与三级医院相关的初级保健诊所收集的数据进行，以证明结构化乳腺癌筛查计划在完善的初级保健环境中的作用。将结果与通过机会性诊断在社区中诊断出的癌症病例的结果进行比较。
纳入研究的292例患者的总体平均生存时间为160个月。在49例患者（p<0.01）的初级保健组中，有统计学意义的存活时间延长了约85个月。发现两组患者之间的临床分期和临床反应率具有统计学意义（p<0.01），其中35名(73.3%)初级保健患者为IIA期及以下，与41（30％）肿瘤患者相比。在初级保健组中被诊断出患有乳腺癌的患者在建立完善的乳腺癌筛查计划中被注意到在早期阶段出现乳腺癌。与肿瘤患者组相比，预后更好，死亡率更低。
我们的研究强调了在沙特阿拉伯和该地区得到良好支持的初级卫生服务中需要结构化的乳腺癌筛查计划。这些方案与改善的生存结果和更有利的临床反应相关。迫切需要以适当的资源提供初级保健服务，以极大地影响患者的发病率和死亡率。
