Breast screening in the emerging world: high prevalence of breast cancer in Cairo

The Cairo Breast Screening Trial (CBST) was designed to evaluate the role of clinical breast examination as a primary screening modality in the context of primary care, as in Egypt breast cancer is usually diagnosed at an advanced stage. A specialised medical centre in Cairo (the Italian Hospital) was selected as the headquarters of the study. The initial target group was women age 35-64 living in a geographically defined area around the Italian Hospital, 4116 being contacted by social workers and invited to attend a Primary Health Centre for clinical breast examination. High rates of breast cancer were observed; 8 per 1000 at the first examination and approximately 2 per thousand among those who attended for re-screening. The initial prevalence suggests that many women in the community with early but palpable breast cancer fail to seek medical attention until their cancer is advanced. The detection rate on re-screening, and after follow-up of those who only received one or no screens, ( approximately 3/1000) is similar to expectation.