Assessment of the impact of national breast cancer screening program in achieving downstaging of breast cancer and improving quality of life of breast cancer patients in Morocco

Study sites:	Rabat and Casablanca, Morocco
Principal investigator (PI) from IARC:	P. Basu
PIs from collaborating institutions:	Dr Karima Bendahhou
Map:
Start date:	2019
Closure date:	Ongoing
Objectives:	To compare the breast cancer cases diagnosed through the program (participants) and those diagnosed outside the program (comparison group) in terms of stage at presentation, management and improvement in quality of life after treatment.
Methodology:	A longitudinal study will be conducted at the oncology centres of Rabat and Casablanca with specialized breast cancer management unit. All the breast cancer patients registered with the oncology centers during the first two years of the study will be approached and will be recruited after obtaining written informed consent. We expect to include in the study about 1500 breast cancer patients (1000 in Rabat oncology center and 500 in Casablanca oncology center) each year. A form will be used to extract information from the medical charts of the breast cancer patients from the oncology centres. Data collection will be made by trained staff through visits of the medical records department (MRD). The records of all the recruited patients will be updated every three months to collect information on the clinical stage, histopathology report of the tumour, estrogen receptor status, the post-operative pathology report, the tumour board decision and the adjuvant (or neo-adjuvant) treatment received. The response to treatment and the disease status and vital status at last follow up will be collected from the follow up records. For quality of life assessment, we will use the third version of the QLQ-C30 questionnaire of the European Organization for Research and Treatment of Cancer (EORTC). We will assess the mean duration between detection by CBE or onset of symptoms and the confirmation of diagnosis and onset of treatment, the distribution of breast cancer stage (clinical TNM and pathology TNM), lymph node status, IHC status and type of treatment, the rate of breast conserving surgeries, the treatment response rate and the functional dimensions and symptoms scores on QOL study and improvement between pre- and post-treatment scores by groups.
Funding:	Institut de Recherche sur le Cancer (IRC)