Abstract 731P
Background
Bangladesh faces a dire cancer challenge, with high morbidity and mortality rates exacerbated by late diagnoses due to the lack of a well-designed screening program. Existing services are often opportunistic and lack systematic outreach and follow-up. This project aimed to develop a framework to inform the implementation and evaluation of an organized community-based screening program for cervical, breast, and oral cancers in Bangladesh.
Methods
The proposed framework utilizes a community-oriented strategy. The model was designed after reviewing existing peer-reviewed literature, consultations with national stakeholders as well as integration of globally accepted practices into existing health processes in Bangladesh. We piloted the model in an eligible population within a Union. Key activities include a cross-sectional study to identify barriers to cancer screening, training community healthcare providers, engaging stakeholders for program sensitization, community mobilization, public awareness campaigns, and systematic implementation, including a referral protocol for positive cases. The evaluation phase uses the Organisation for Economic Co-operation and Development (OECD) evaluation criteria to assess its relevance, effectiveness, efficiency, impact, and sustainability. Implementation started in April 2024 and is currently ongoing.
Results
To date, 1179 households have been approached for registration and consent. Out of 4834 household members, 51.2% (n=2476) individuals are eligible for our screening program. 51.8% (n=1282) are female. Out of the at-risk females, only 74.2% (n=951) are aware of their risk for cervical cancer, and 55.9% (n=716) are aware of their risk of breast cancer. Only 50.6% (n=603) of at-risk males are aware of their risk of oral cavity malignancies. 97.4% (n=2412) of respondents interviewed have expressed their interest in participating in the screening program.
Conclusions
The successful implementation and evaluation of this pilot program will provide vital insights to inform future policy decisions and potentially guide national strategies for cancer control in Bangladesh and similar communities globally.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
SingHealth Duke-NUS Global Health Institute Pilot Grant 2023.
Disclosure
R. Kanesvaran: Financial Interests, Institutional, Invited Speaker: Astellas, Johnson and Johnson, Ipsen, Amgen, BMS, MSD, Novartis, AstraZeneca, Sanofi, Merck; Financial Interests, Institutional, Advisory Board: Johnson and Johnson, Pfizer, Ipsen, Amgen, BMS, MSD, Bayer, AstraZeneca, Ferring; Financial Interests, Institutional, Research Grant: Sanofi, Eisai, Johnson and Johnson; Non-Financial Interests, Personal, Leadership Role, Past President: Singapore Society of Oncology, SIOG; Non-Financial Interests, Personal, Leadership Role, Vice Chairman: Singapore Cancer Society; Non-Financial Interests, Personal, Leadership Role, Medical Advisory Board Member: International Kidney Cancer Coalition. All other authors have declared no conflicts of interest.