Development of a National Breast Cancer Screening Policy in Jamaica

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Too many Jamaican women are dying from breast cancer. Although the rate of breast cancer was expected to rise with the introduction of mammography, as it did in other countries, it has remained relatively stable. This discordance is due to Jamaica’s under-utilization of mammography services and lack of a national breast cancer screening policy. In the absence of a screening policy, many cancers go undetected at early stages when cancer is most treatable.

Currently, mammography is not available in the public sector, effectively excluding those who cannot afford it at a private clinic or pay for the lower cost mammography through the Jamaica Cancer Society (JCS). Furthermore, those women who can pay are unlikely to seek screening without a physician referral. A national screening policy would standardize age at screening, encourage mammogram referrals, and allocate funding for public mammography services. This policy may also encourage partnerships amongst the stakeholders to provide additional sources and mobilize all available resources.

Though many stakeholders support the development of a screening policy, governmental action has been stagnant due to funding limitations. The JCS has been active in raising breast cancer awareness and providing screening services to low-income individuals, but it is severely handicapped by lack of funding. Furthermore, with the threat of increasing breast cancer incidence due to wider adoption of western diets and lower exercise levels, more women are at risk for developing disease that may go undetected.

We are calling for the development of a national breast cancer screening policy in Jamaica and we urge the Ministry of Health to act now in making this a national priority. The cost of implementing such a policy should be viewed in the broader context of cost savings from the early detection of breast cancer and thus decreased utilization of expensive late stage cancer care.

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3 Responses to “Development of a National Breast Cancer Screening Policy in Jamaica”

  1. mbarna0523 Says:

    Excellent post. I was wondering about the concept of pressure points. Assuming that your advocacy inspires the Jamaican government to pass legislation creating a national policy, how do you ensure policy implementers (Ministry of Health, JSC) will act and create suitable programs for all economic levels? Also, will this be part of a push to expand primary care? Are there services to handle positive mammogram results (frequent false positives) through diagnostic imaging/ultrasound/biopsy? I think these may be additional steps for future advocacy as your initial efforts succeed.

  2. sarahbarkle Says:

    Women should have access to mamography for early detection of breast cancer regardless of their socio-economic status. I agree with the poster above that it needs to be integrated into the larger healthcare system. Some of this integration can be built into the breast cancer screening program- automatic referrals, call backs, and cutting out the ‘middleman’. Having a variety of stakeholders involved in developing a national policy and national guidelines can help to identify those possible program/policy gaps. There are definitely inherent risks involved in any screening program including costs and morbidity of unnecessary tests and procedures. However, early detection and intervention in breast saves lives and your efforts to remove the existing barriers is inspiring. Thank you for your post and good luck with your efforts!

  3. hlian Says:

    I truly enjoy this blog posting. The proper research evidence to support such a policy change is listed. The previous challenges preventing such national screening program to be wide implemented have been identified. However, I would also like to see more details how the newly proposed policy can be executed. I would imagine that making mammography available in the public sector will take a coordinated effort between different government agencies. The blog has pointed out that capital deployment would be a key concern – but it is unclear how this would be addressed if breast cancer screening becomes a national policy.

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