Enhancing Rural Breast Cancer Screening Uptake: A Three-Arm Comparative Study of Outreach Strategies.

Abstract

Background: Breast cancer is the most prevalent cancer among women, with a notably high mortality-to-incidence ratio, especially in rural areas. Limited awareness and inadequate access to healthcare are major contributors to the high breast cancer mortality rate in rural women, often resulting from insufficient screening, delayed diagnosis, and treatment.

Objectives: This study is aimed at evaluating the effectiveness of three distinct intervention strategies-medical personnel-led education, breast health volunteers, and mobile screening mammography van visits-in improving breast cancer awareness, increasing screening participation, and reducing associated stigmatization among rural women.

Methods: A comparative, community-based interventional study was conducted in three villages in neighboring districts. Rural communities were randomly allocated to one of the three intervention strategies. Baseline and postintervention data were collected using validated structured questionnaires assessing breast cancer knowledge, screening practices, stigma, and perceived barriers.

Results: A total of 944 women aged 30-70 years were enrolled in the study. Overall, 63.7% of participants underwent screening. The mobile screening mammography van group achieved the highest screening uptake (68.7%) and the greatest increase in awareness scores, whereas the breast health volunteer-led group showed the most significant reduction in stigma. The medical personnel-led group, though cost-effective in raising awareness, recorded lower screening participation and reported higher perceived barriers to screening mammography (e.g., transport, time, and financial constraints).

Conclusion: The findings demonstrate that integrated, culturally tailored interventions, particularly those combining community engagement with accessible on-site screening services, can effectively improve breast cancer awareness and screening uptake among rural women. Scaling up such multicomponent strategies may help overcome logistical and sociocultural barriers, ultimately contributing to earlier detection and reduced mortality.