Breast cancer screening for everyone.

Author(s) Patrick Brander1, Marius Besson2, Béatrice Arzel3
Affiliation(s) 1Service de médecine de premier recours, University Hospital Geneva, Geneva, Switzerland, 2Service de médecine de premier recours, University Hospital Geneva, Geneva, Switzerland, 3Fondation genevoise de dépistage du cancer du sein, Fondation genevoise de dépistage du cancer du sein, Geneva, Switzerland.
Country - ies of focus Switzerland
Relevant to the conference tracks Social Determinants and Human Rights
Summary As breast cancer is the most prevalent cancer in women, a screening program has been developed in the canton of Geneva since 1999. The University Hospital’s CAMSCO service (Consultation ambulatoire mobile de soins Communautaires) is devoted to people living in precarious conditions which includes mainly undocumented migrants and women working in the domestic’s fields, those without health insurance, and inclusive of those aged over 50 years old. Since 2006 a collaboration between the cantonal breast cancer screening program and the CAMSCO was developed allowing for these undocumented women to have access to information in their own language and also mammography screening. Since 2008 280 women have had mammography screening.
What challenges does your project address and why is it of importance? Access to health systems for undocumented migrants in Switzerland is difficult and differs greatly between cantons. Some swiss cantons have organized a system to allow these people to have access to primary care and preventive medicine. Breast cancer screening is recommended by international guidelines and should, as such, be offered to every women between 50 and 74 years old.
How have you addressed these challenges? Do you see a solution? A collaboration between the CAMSCO and the “Geneva Breast Screening program” has been developed since 2006, allowing the undocumented women between 50 and 74 years old and living in Geneva to be offered mammography screening. This program is financially supported by public funds and the mammography itself is paid 90% by patients’ insurance with a 10% (19.15.-swiss francs) contribution by the patient. The exception is disadvantaged women, for whom this amount is supported by screening program through private funds.
How do you know whether you have made a difference? Due to this collaboration 280 migrants women without health insurance had access to mammography screening. Their number has been about stable since 2010 averaging 65 for each year.
Have you or the project mobilized others and if so, who, why and how? The project has mobilized the Geneva hospital gynecology service as they do the mammography and assure that any anomaly is investigated and treated as needed. Medical doctors working in the Geneva hospital primary care service are also encouraged to plan mammography for their undocumented migrants as indicated
When your donor funding runs out how will your idea continue to live? Our collaboration may be funded by public funds, as it is already in part. Otherwise, it could only be funded by patients themselves, which is impossible.

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