Performance and territorial governance assessment of the National Breast Cancer Screening Program in Taza Province, Morocco (2022–2024)

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DOI:

https://doi.org/10.15584/ejcem.2026.2.10

Keywords:

breast cancer screening, early detection of cancer, health information systems, patient compliance, public health programs, screening programs

Abstract

Introduction​‍​‌‍​‍‌ and aim. Breast cancer is one of the leading causes of cancer-related mortality among women in Morocco. This study assessed the performance of the National Breast Cancer Screening Program (NBCSP) in Taza Province from 2022 to 2024. focusing on screening coverage, participation, detection indicators, and territorial equity.

Material and methods. We analyzed Health Information System data from 74,269 women aged 40–69 years eligible for screening. Temporal trends and rural–urban differences in screening participation and diagnostic completion were assessed using appropriate statistical models.

Results. Screening participation among the women contacted was between 54.8% and 82.0%, while overall coverage remained around 50% of the eligible population. The breast cancer detection rate was raised from 1.35 to 2.12 per 1,000 women screened. Clinical breast examination positivity was almost unchanged and low (≈2.4%). After adjustment, rural residence was associated with lower odds to participate in the screening, to complete referral and biopsy, and to get timely diagnosis within 60 days.

Conclusion. While positive changes were made in screening activities and detection indicators, there are still gaps in program quality and equity. The absence of systematic stage-at-diagnosis data limits interpretation of clinical impact and underscores the need for integrated data systems to improve breast cancer screening evaluation in ​‍​‌‍​‍‌Morocco.

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References

Perry N, Broeders M, de Wolf C, Törnberg S, Holland R, von Karsa L. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition--summary document. Ann Oncol. 2008;19(4):614-622. doi:10.1093/annonc/mdm481

World Health Organization. WHO Position Paper on Mammography Screening. WHO Press; 2023. Accessed September 20, 2025. https://www.who.int/publications/i/item/9789241507936. Accessed September 20, 2025.

Basu P, Ponti A, Anttila A, et al. Status of implementation and organization of cancer screening in The European Union Member States-Summary results from the second European screening report. Int J Cancer. 2018;142(1):44-56. doi:10.1002/ijc.31043

Aboulhoda F, Erefai O, Bejja F, Soulaymani A, Mokhtari A, Hami H. Breast cancer epidemiology and clinical outcomes in Moroccan women: a six-year retrospective study. Pan Afr Med J. 2024;49:120. doi:10.11604/pamj.2024.49.120.42588

International Agency for Research on Cancer. Cancer screening in the European Union: status report 2022. International Agency for Research on Cancer; 2022. Accessed September 20, 2025.https://health.ec.europa.eu/system/files/2022-09/com_2022-474_act_en.pdf.

World Health Organization Regional Office for the Eastern Mediterranean. Cancer control in the Eastern Mediterranean Region: progress and challenges. World Health Organization Regional Office for the Eastern Mediterranean; 2024. Accessed September 20, 2025. https://applications.emro.who.int/dsaf/dsa406.pdf. Accessed September 20, 2025.

International Agency for Research on Cancer, Ministry of Health of Morocco. National Cancer Prevention and Control Plan 2017–2021. Ministry of Health; 2017.

Frikha H, Dhouib M, Bougatef S, Kochbati L, Maalej M, Ben Abdallah M. Breast cancer screening in Tunisia. East Mediterr Health J. 2013;19(3):S70-S76.

Samah AA, Ahmadian L. Breast cancer screening in Iran: a systematic review. Asian Pac J Cancer Prev. 2012;13(7):3031-3036.

International Agency for Research on Cancer. Cancer Screening in the European Union: Report on the Implementation of the Council Recommendation on Cancer Screening. IARC; 2017.

Weedon-Fekjaer H, Romundstad PR, Vatten LJ. Breast cancer incidence and mortality in Norway, 1995–2014. Acta Oncol. 2016;55(1):1-9.

Karayurt O, Ozmen D, Cetinkaya AC. Knowledge and attitudes of breast self-examination and mammography in rural Turkey. BMC Cancer. 2012;12:43. doi:10.1186/1471-2407-12-43

Giordano L, Castagno R, Giorgi D, et al. Breast cancer screening in Italy: evaluating key performance indicators for time trends and activity volumes. Epidemiol Prev. 2015;39(3 Suppl 1):30-39.

Pearson K. Notes on regression and inheritance in the case of two parents. Proc R Soc Lond. 1895;58:240-242.

Anderson BO, Ilbawi AM, Fidarova E, et al. The Global Breast Cancer Initiative: a strategic collaboration to strengthen health care for non-communicable diseases. Lancet Oncol. 2021;22(5):578-581. doi:10.1016/S1470-2045(21)00071-1

Ermiah E, Abdalla F, Buhmeida A, Larbesh E, Pyrhönen S, Collan Y. Diagnosis delay in Libyan female breast cancer. BMC Res Notes. 2012;5:452. doi:10.1186/1756-0500-5-452

Ministry of Health and Population. National Cancer Control Strategy 2023–2027. MoHP; 2023.

Molinié F, Leux C, Delafosse P, et al. Waiting time disparities in breast cancer diagnosis and treatment: a population-based study in France. The Breast. 2013;22(5):810-816. doi:10.1016/j.breast.2013.02.009.

Vandergrift JL, Niland JC, Theriault RL, et al. Time to adjuvant chemotherapy for breast cancer in National Comprehensive Cancer Network institutions. J Natl Cancer Inst. 2013;105(2):104-112. doi:10.1093/jnci/djs506

World Health Organization Regional Office for the Eastern Mediterranean. Guide to Setting Up Breast Cancer Screening Programs. WHO-EMRO; 2015. Accessed September 20, 2025. https://www.emro.who.int/noncommunicable-diseases/summaries/guidelines-for-the-early-detection-and-screening-of-breast-cancer.html?utm_source=chatgpt.com.

Biesheuvel C, Weige S, Heindel W. Mammography screening: evidence, history, and current practice in Germany and other European countries. Breast Care (Basel). 2011;6(2):104-109. doi:10.1159/000327493

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Published

2026-03-08

How to Cite

Aboujihad , E., Lamiri , A., Siabi , A., Belhaj , H., Benfatah , M., Qaisar , R., Ghosne , N., & El Idrissi , M. B. D. (2026). Performance and territorial governance assessment of the National Breast Cancer Screening Program in Taza Province, Morocco (2022–2024). European Journal of Clinical and Experimental Medicine. https://doi.org/10.15584/ejcem.2026.2.10

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ORIGINAL PAPERS