Determining the most suitable target age-group for breast cancer screening in Samoa.
Main Article Content
Keywords
breast, cancer, incidence, screening, Samoa
Abstract
Introduction: Cancer is the second leading cause of non-communicable related deaths in Samoa, accounting for 15% of deaths after cardiovascular diseases.1 Samoa’s incidence of cancer has increased from 28.5 per 100,000 in 2007 to 65.2 per 100,000 in 2016.2 Samoans are at risk of various cancers, including breast, because of their high prevalence of major risk factors such as obesity, overweight, physical inactivity, alcohol and smoking.3,4,5 Breast cancer is the most common cancer type in females,2,6 and it is the leading cause of deaths from cancer among the Samoan female population.1,7
Methods: This was a retrospective study that analysed laboratory confirmed breast cancer cases diagnosed in the Tupua Tamasese Meaole Hospital at the Clinical Laboratory from 20072020.
Findings/Outcomes measure: We found that breast cancer incidence has dramatically increased over the twelve-year period with an incidence rate of 8.0 per 100,000 in 2007 to 31.3 per 100,000 in 2020, and it is affecting women as young as 21 to 86 years old. 80% of breast cancer cases had their first diagnosis detected at age 45 years or older. We also observed that screening targeting women aged 4574 years based on the crude incidence rate would detect 74.6% of cases, and this would be suitable for Samoa considering the lack of screening for its female population and limited available resources.
Conclusions: It is undeniable that Samoa’s incidence rate for breast cancer is increasing. It is fundamental for Samoa to establish a population-based screening programme to enhance the early detection of breast cancer and equally important to develop a population-based national cancer registry to strengthen its cancer surveillance. Whether Samoa decides to follow a breast cancer screening programme based on mammography or physical examination, a well-defined age group must be determined.
References
2. Amosa-Lei Sam F, Akinremi A, Mery L, et al. Cancer incidence in Samoa: a 10-year retrospective survey (2007-2016). Asia Pac J Public Health. 2020;33:6-7. doi: 10.1177/1010539520975261.
3. Samoa Ministry of Health. National communicable disease control policy 2018-2023 [Internet]. Samoa Ministry of Health; 2018 September [cited 2023 February 6]. Available from: https://extranet.who.int/nutrition/gina/sites/default/filesstore/WSM_2018_National%20%20Noncommunicable%20%20Disease%20Control%20Policy%20%202018%20%E2%80%93%202023%20.pdf
4. Linhart C, Naseri T, Lin S, et al. Tobacco smoking trends in Samoa over four decades: can continued globalization rectify that which it has wrought? Global Health. 2017;13(1):31. doi: 10.1186/s12992-017-0256-2.
5. Helble M, Sato A. Wealthy but unhealthy; overweight and obesity in Asia and the Pacific: trends, costs and policies for better health [Internet]. Asian Development Bank Institute; 2018 July [cited 2023 February 6]. Available from: https://www.adb.org/publications/wealthy-unhealthy-overweight-and-obesity-asia-and-pacific-trends-costs-and-policies
6. International Agency for Research on Cancer. Estimated age-standardized incidence and mortality rates (world), in 2018, Samoa, female, all ages [Internet]. International Agency for Research on Cancer; Updated 2018 [cited 2023 February 6]. Available from: https://gco.iarc.fr/today/home
7. International Agency for Research on Cancer. Samoa fact sheet – Global Cancer Observatory [Internet]. International Agency for Research on Cancer; 2021 March [cited 2023 February 6]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/882-samoa-fact-sheets.pdf
8. Kulkarni S, Dean S. Surveillance of cancer cases in TTM hospital: a retrospective study of 5 years. SMJ. 2010;2(2):6-10.
9. Paksoy N, Bouchardy C, Parkin DM. Cancer incidence in Western Samoa. Int J Epidemiol. 1991;20(3):634-641. doi: 10.1093/ije/20.3.634.
10. Australian Government Department of Health. Breast screen Australia [Internet]. Australian Government Department of Health; Updated 2015 March 5 [cited 2023 February 6]. Available from: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/breast-screening-1
11. New Zealand Ministry of Health. Impact analysis: extending breast screen Aotearoa to include women aged 70-74 years [Internet]. New Zealand Ministry of Health; 2019 May [cited 2023 February 6]. Available from: https://www.nsu.govt.nz/system/files/resources/impact-analysis-extending-age-range-breastscreen-aotearoa-may19.pdf
12. Anderson BO, Tsu VD. Breast cancer in low and middle income countries: How can guidelines best be disseminated and implemented? Breast Care (Basel). 2008;3(1):6-8. doi: 10.1159/000116365.
13. World Health Organization. Cancer: breast cancer prevention and control [Internet]. World Health Organization; Updated 2020 [cited 2023 February 6]. Available from: https://www.who.int/cancer/detection/breastcancer/en/index3.html
14. International Agency for Research on Cancer. Breast cancer screening IARC handbooks of cancer prevention [Internet]. International Agency for Research on Cancer; 2016 [cited 2023 February 6]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546556/
15. O’brien J. Diagnosis and the triple test [Internet]. St Vincent’s Private Hospital; [cited 2023 January 2]. Available from: https://www.melbournebreastcancersurgery.com.au/diagnosis-and-the-triple-test.html
16. Breast Cancer Foundation NZ. The triple test [Internet]. Breast Cancer Foundation NZ; [cited 2023 January 21]. Available from: https://www.breastcancerfoundation.org.nz/breast-cancer/tests-and-diagnosis/the-triple-test
17. New Zealand Ministry of Health. Breast cancer [Internet]. New Zealand Ministry of Health; Updated 2020 August 31 [cited 2023 February 6]. Available from: https://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/breast-cancer
18. Cancer Council. Early detection of breast cancer [Internet]. Cancer Council; [cited 2022 October 2]. Available from: https://www.cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/early-detection-of-breast-cancer
19. Australian Government Department of Health. Breast screen Australia: program evaluation [Internet]. Australian Government Department of Health; Updated 2014 October 24 [cited 2023 February 6]. Available from: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/programme-evaluation
20. Sarfati D, Dyer R, Amosa-Lei Sam F, Barton M, Bray F, Buadromo E, et al. Cancer control in the Pacific: big challenges facing small island states. Lancet Oncol. 2019;20(9):e475-e492. doi: 10.1016/S1470-2045(19)30400-0.
21. World Health Organization. Cancer country profile – Fiji [Internet]. World Health Organization; Updated 2014 [cited 2022 October 2]. Available from: https://www.who.int/cancer/country-profiles/fji_en.pdf?ua=1
22. The World Bank. Population, female – Samoa [Internet]. The World Bank; 2020 [cited 2022 December 12]. Available from: https://data.worldbank.org/indicator/SP.POP.TOTL.FE.IN?end=2021&locations=WS&start=2001
23. Samoa Bureau of Statistics. 2016 Population and Housing Census Samoa Gender Dynamics Monograph [Internet]. Samoa Bureau of Statistics; 2020 April [cited 2022 December 5]. Available from: https://www.sbs.gov.ws/images/sbs-documents/info-graphics/SGM/SGM_FINAL_web_4oct.pdf
24. World Health Organization. WHO classification of tumours – breast tumours [Internet]. World Health Organization; 2019 [cited 2022 October 4]. Available from: https://publications.iarc.fr/581
25. Marcus PM. Assessment of cancer screening: a primer [Internet]. National Cancer Institute (US); 2019 November [cited 2022 October 5]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK550212/
26. Samoa Bureau of Statistics. Samoa gender monograph 2019: gender and health current status and implications [Internet]. Samoa Bureau of Statistics; 2019 [cited 2023 February 6]. Available from: https://www.sbs.gov.ws/images/sbs-documents/info-graphics/SGM/SGM_PB3_Health_2aug.pdf
27. World Health Organization. Breast cancer [Internet]. World Health Organization; 2021 March 26 [cited 2023 January 4]. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer
28. Hadi MA, Ratrout HA, Wadaani HA. Rethinking: ideal screening age for breast cancer in developing countries. J Breast Health. 2015;11(3):111-114. doi: 10.5152/tjbh.2015.2560.
29. World Health Organization. WHO position paper on mammography screening [Internet]. World Health Organization; 2014 [cited 2023 February 9]. Available from: file:///Users/amopi058/Downloads/WHO%20position%20paper%20on%20mammography%20screening%20(1).pdf
