Abstract PO5-07-12: Feasibility of organized population-based mass-level mammography screening (0.2 million women) –Report from LMIC-Uzbekistan
Authors: Tillyashaykhov Mirzagaleb , Seytmuratova Aysulu , Ososkov Alexander , Djanklich Saide , Ziyaev Yakhyo , Pendharlkar Dinesh 
Published: May 2024

Background. Breast cancer is one of the leading diseases worldwide. The early detection of breast cancer is the best way to improve survival. Mammography is included in the standard guidelines of all the leading organizations. The procedure is technically demanding and cost sensitive. Despite being a standard, it is not practical in many countries, and more so in LMIC. The state of Uzbekistan embarked on a massive, unique, organized population-based program of mass-level mammography screening, starting from one region of the country and expanding to others. Here, we report the process of such establishment and the feasibility of this innovative model.

Methods. Realizing the importance of breast cancer screening, the Republic of Uzbekistan initiated a pilot project in the Bukhara Region. The area is divided into 12 districts. Every district was equipped with a stationary mammography machine in a regional polyclinic and one mobile van. The personnel were appropriately trained and a selection process was established to invite women for screening. The invitation was sent using the local area's existing municipality residential directory, which contains the complete demographic details of every individual living in the area. The state has 100 % coverage in the registry. The study targeted every woman aged 45-65 starting May 2021. All mammographs were digitally recorded and sent in real time to a centralized server at the National Republican Cancer Center in Tashkent, Uzbekistan. Reporting is performed at a centralized reading center on the information system platform. The program envisages a complete care pathway, from screening to diagnosis and treatment.

Results. Over a period of two years, 140506 women in the age range–45-65 underwent mammography screening. Depending on the size of the target group of the district, an average of 30-60 mammograms were performed per day. A reported preliminary analysis shows the presence of BIRADS 0 in 4495, BIRADS 1 IN 78634, BIRADS 2 in 64345, BIRADS 4 in 4998, BIRADS 5 in 893. All women with BIRADS 4 and 5 were referred to the regional comprehensive cancer center for further evaluation.

A total of 7570 patients underwent cytology and 408 underwent core biopsy. Depending on the reports, the patients were appropriately managed. A total of 1885 patients were recalled for additional screening owing to their inappropriate quality. After a year of function, the project was expanded with “Mobile Vans” to other regions of the country. An additional 13 mobile mammography vans were added after 1.5 years. From January 2023, approximately 50000 mammograms were additionally performed, taking the total number of screened women to 190506.

Conclusion. Thus, it is feasible to plan and successfully implement state-owned mass-level mammography screenings. This project has the potential for duplication in any part of the world, and other organizations can learn from this extensive, wide program.

Citation Format: Mirzagaleb Tillyashaykhov, Aysulu Seytmuratova, Alexander Ososkov, Saide Djanklich, Yakhyo Ziyaev, Dinesh Pendharlkar. Feasibility of organized population-based mass-level mammography screening (0.2 million women) –Report from LMIC-Uzbekistan [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-07-12.