Prioritizing Mammography Screening in Developing Countries: Are We Putting the Cart Before the Horse?

Excerpt

Many low- and middle-income countries (LMICs), including India, Kazakhstan, Lebanon, South Africa, Uzbekistan, and Indonesia, are prioritizing the implementation of population-based mammography screening with the hope of reducing the burden of breast cancer mortality.^1‐6 However, those who advocate population-based screening in these countries often fail to recognize that the benefit of breast cancer screening is inextricably linked to the availability of effective breast cancer treatments. That is, to fully discern the benefits of breast cancer screening, effective treatment infrastructures must first be in place. Hence, we believe that prioritizing cancer screening in LMICs is misguided and is akin to putting the cart before the horse. In low-resource settings, priority should be given to the implementation of effective treatment infrastructures, and screening should only be considered after effective treatments are widely available. Moreover, we believe that screening clinical breast examination (CBE), which has been validated as an effective low-cost screening method in India, should be considered as the breast cancer screening method of choice in low-resource settings.⁷ …