Breast Cancer Screening in Sarawak, Borneo: 10 Years' Community Outreach Program.

Area of Science:

• Oncology
• Public Health
• Rural Health

Background:

• Sarawak, Malaysia's largest state, has 45% of its 2.9 million population living remotely.
• Limited healthcare access in rural Sarawak increases the risk of delayed breast cancer diagnosis.
• Only four government hospitals in Sarawak offer diagnostic mammogram facilities.

Purpose of the Study:

• To evaluate the 10-year impact of breast cancer education and early screening outreach programs in Sarawak.
• To analyze breast cancer screening data focusing on rural communities.
• To identify factors associated with abnormal breast findings in the screened population.

Main Methods:

• Community-based breast cancer screening programs were conducted from 2013 to 2023.
• Programs involved clinical breast examinations for women aged 18 and above.
• Referrals for further management were provided for women with abnormal findings.

Main Results:

• A total of 2050 women were screened, with 7.1% showing abnormal breast findings.
• Higher rates of abnormal findings were observed at urban screening sites (9%) compared to rural sites (5%).
• Malays (9.5%) and women with fewer than three children (8.3%) showed higher percentages of abnormal findings.

Conclusions:

• Screening site location was the most significant factor for detecting breast abnormalities.
• Reproductive health, specifically the number of children, correlated with abnormal findings, potentially influenced by socioeconomic and cultural factors.
• The study highlights the importance of targeted screening programs in addressing disparities in breast cancer diagnosis.