ORGANIZING EARLY DIAGNOSIS AND SCREENING PROGRAMS FOR BREAST CANCER IN TURKEY
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Research Article
P: 125-134
July 2009

ORGANIZING EARLY DIAGNOSIS AND SCREENING PROGRAMS FOR BREAST CANCER IN TURKEY

Eur J Breast Health 2009;5(3):125-134
1. Prof. Dr., Genel Cerrahi Anabilim Dalı Öğretim Üyesi, Ulusal Kanser Danışma Kurulu Üyesi, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Başkanı, İstanbul Üniversitesi İstanbul Tıp Fakültesi, Çapa, İstanbul
2. Doç. Dr., Halk Sağlığı Uzmanı, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi, İzmir İl Sağlık Müdürlüğü
3. Op. Dr., Genel Cerrahi Uzmanı, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi , Ali Osman Sönmez Onkoloji Hastanesi, Bursa
4. Doç. Dr., Patoloji Uzmanı, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi , Tepecik Eğitim ve Araştırma Hastanesi, İzmir
5. Eğitim Şube Müdürü, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi, Sağlık Bakanlığı Kanserle Savaş Dairesi Başkanlığı, Ankara
6. Prof. Dr., Tıbbi Onkoloji Uzmanı, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi Ege Üniversitesi Tıp Fakültesi,Tıbbi Onkoloji Bilim Dalı, İzmir
7. Doç. Dr., Genel Cerrahi Anabilim Dalı Öğretim Üyesi, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi, Marmara Üniversitesi Tıp Fakültesi, İstanbul
8. Doç. Dr., Tıbbi Onkoloji Bilim Dalı Öğretim Üyesi, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi Dicle Üniversitesi Tıp Fakültesi, Diyarbakır
9. Prof. Dr., Radyoloji Anabilim Dalı Öğretim Üyesi, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi Uludağ Üniversitesi Tıp Fakültesi, Bursa
10. Patoloji Uzmanı, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi Bakırköy Dr. Sadık Onur Eğitim ve Araştırma Hastanesi, İstanbul
11. Prof. Dr., Genel Cerrahi Anabilim Dalı Öğretim Üyesi, Ulusal Meme Kanseri Erken Tanı ve Tarama Alt Kurulu Üyesi, Kocaeli Üniversitesi Tıp Fakültesi, İzmit
12. Doç. Dr.Ulusal Kanser Danışma Kurulu Üyesi, Ankara Onkoloji Hastanesi Başhekimi, Ankara
13. Prof. Dr. Kanserle Savaş Dairesi Başkanı, Hacettepe Üniversitesi Tıp Fakültesi, Pediatrik Hematoloji Bilim Dalı Öğretim Üyesi
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ABSTRACT

Background:

Breast cancer is the most commonly seen and cause of cancer deaths in women in most of the developed and developing countries. Breast cancer awareness and organized population based screening programmes have resulted in early diagnosis, reduction in mortality, and breastconserving surgery. Therefore, body image of women suff ered from breast cancer has been protected, and overall survival rate has increased. Eighty-four KETEM’s (Cancer Early Detection and Screening Center) in 81 provinces in Turkey has been founded by Cancer Control Department of The Ministry of Health of Turkey. Opportunistic screening has been performed in these centers; however there are no available data regarding the eff ect of opportunistic screening on breast cancer mortality. Population based organized screening programmes should be implemented to reach this aim.

Aim:

The aim is to organize national early diagnosis and screening programs consistent with the conditions of country, that are necessary for early diagnosis and treatment of breast cancer which is the most frequently seen female cancer with gradually increasing incidence in our country.

Methods:

National Cancer Advisory Board, Breast Cancer Early Detection and Screening Sub-Committee organized three meetings in Ankara in 2008. In addition to those three-day workshops, a fourth one was performed in January 22-24, 2009 to provide reports from those studies. In these meetings, expert panelists selected by The Ministry of Health, National Cancer Advisory Board, and National Federation of Breast Societies shared their experiences and knowledge on early detection and screening of breast cancer in Turkey. Two representatives from the World Health Organization also attended to the third meeting. During those meetings, targets and strategies for early detection and screening for breast cancer had been evaluated. Possible barriers to screening, their eliminations, methods of follow up the prepared programme step by step had also been discussed.

Results:

To reach the success with early detection and screening programs is not possible without community awareness about the importance of early detection and especially high-level awareness of the target population. For this reason, education of women and increasing breast cancer awareness should be the fi rst step. Health care providers (physicians, nurses, midwives etc.) and their administrators (health administrators, chief of staff in hospital etc.) should also be trained and included in those programs. A realistic budget for screening projects should be prepared and carried out. There should be a high-level coordination and a comprehensive organization among study groups, screening centers, and institutions. Social, cultural, and other possible regional barriers against the implementation of projects should be explored and eliminated. Activities, performance status and available data should be controlled, evaluated and published periodically. Targets, strategies, activities, criteria relationships with other related organizations should be re-evaluated, and performance should be monitored regularly.

Conclusions:

Organizing and implementing breast cancer early detection and screening programmes could be possible only with comprehensive, planned in details, and well determined studies. Resources should be used carefully and timely whenever necessary. As a result of this, downstaging of breast cancer and reduction in mortality rate in community could be possible.

Keywords:
early detection, screening, breast cancer, awareness, national screening programs, Turkey