By CAROLINE CUNHA
THE ALGARVE’S first breast screening programme, launched last September by the Associação Oncológica do Algarve (AOA), the Algarve Oncology Association in conjunction with the Algarve University and the Algarve regional health authority, is already proving effective, according to findings contained in the first report.
By May of this year, 3,473 women had been screened in the boroughs of Alcoutim, Castro Marim, Vila Real de Santo António, Tavira and Olhão (although the screening was still in progress in Olhão when the report was compiled). So far, a total of 128 women were identified as needing additional assessment to determine if breast cancer was present and eight of those women, in whom the disease was detected early, have already been treated.
How did the screening programme begin?
Following the success of the Mamamaratona events (fun runs with proceeds going to the AOA – see page 32 for details of this year’s event) and an EU funding grant, the AOA acquired a digital mobile mammography unit in June of 2005, in order to begin a breast screening programme in the Algarve.
The mobile unit travels across the region stopping at the main Centros de Saúde (public health centres) in each city. Patient lists are held by the regional health authority and women, aged between 50 and 65, are sent an invitation to come to the unit when it comes to their area. The aim of the programme is for every woman in the Algarve, within this age range, to have a mammogram in order to facilitate the early detection of breast cancer.
In terms of response, it was noted that women from the interior were much more receptive to the programme. Alcoutim leads with 244 mammograms having been carried out, Castro Marim is next on the list, with a 63 per cent response rate, while in Vila Real de Santo António and Tavira, the rate was considerably lower with only 49 per cent of those eligible to take part choosing to do so.
In global terms, from a total of 9,406 women invited to take part in the screening programme during the period covered by the report (September 2005 to May 2006), 3,473 came to the unit to have a mammogram made, equating to a 37 per cent response rate.
The breakdown by age-group was as follows: 1,012 women were screened aged between 50 and 54, 1,151 between the ages of 55 and 59 and 1,313 between the ages of 60 and 65.
With regards to diagnostic assessment, 128 women screened at the unit received a non-negative result, meaning that an additional assessment was needed to determine if cancer was present. Of these 128, eight cases of breast cancer were detected after biopsies were carried out. The women immediately underwent treatment. Exact details of their treatment has not been made available due to confidentiality reasons, but every case was different, with the medical specialists making decisions based upon tumour size and the condition of each patient’s general health.
A further 5,000 women have been screened at the unit since May in the boroughs of São Brás and Loulé, but the data has not yet been compiled from these locations.
Room for improvement
As the programme is only in its first year, it was to be expected that the report would identify some aspects that require improvement. Teresa Figueiredo, the mobile unit’s radiologist who compiled the report, identified that the patient lists, supplied by the Algarve regional health authority, are not entirely accurate. The database apparently contains various errors relating to personal details such as address, age and sex, which meant that some members of the target group were not reached.
Figueiredo also noted the absence of an intermediary structure between the Algarve regional health authority and the medical staff at the centres, which is fundamental, since it is the doctors and nurses who should be promoting the screening programme and providing patients with the necessary information. Figueiredo considered that both these issues had affected the success of the screening programme so far.
The Resident contacted Maria de Lurdes Santos Pereira of the AOA for her reaction to the report’s findings.
“We are in constant contact with the Algarve regional health authority and hold regular meetings. The database issue has been discussed and measures are being taken to improve the accuracy of the patient details held on the computer system. It was the first time the health authority had supplied data for such purposes and so it was expected that some teething problems would be experienced,” she said.
With regard to the lack in communication, Maria de Lurdes told The Resident that the AOA’s volunteers are doing what they can to solve this situation, but that receiving more support from the media would be extremely helpful in order to raise more awareness of the programme. “We would like to hear the breast screening programme being promoted on local radio, as well as in the newspapers,” she said.
“Overall we are very pleased so far. We didn’t know exactly what to expect, but we can definitely see that launching this screening programme was absolutely necessary. There are many cancer sufferers in the Algarve and this programme will help to identify new cases at an early stage so that effective treatment can be given.”
The mobile unit is currently stationed at the main Central de Saúde in Loulé and the next stop for the unit is Albufeira. The AOA has provided The Resident will the unit’s schedule for the next nine months, in order for interested readers to see when the mobile unit will be visiting their area.
For further details about the programme contact the AOA on 289 807 531 or visit www.aoa.pt. The AOA stresses to women that it is very important to apply for a Cartão de Utente (health card) at their local health centre if they don’t already have one, otherwise they will not be called up to take part in the screening programme.
Mobile Mammography unit’s schedule
From October 20, 2006: Centro de Saúde de Albufeira
From December 15, 2006: Centro de Saúde de Silves
From February 9, 2007: Centro de Saúde de Lagoa
From March 19, 2007: Centro de Saúde de Monchique
From March 30, 2007: Centro de Saúde de Aljezur
From April 16, 2007: Centro de Saúde de Vila do Bispo
From April 27, 2007: Centro de Saúde de Lagos
From June 18, 2007: Centro de Saúde de Portimão
From June 31, 2007: Centro de Saúde de Faro