Needs for Cancer Education In Oman Based on the Breast Cancer Screening Program.

Most breast cancers in Oman are diagnosed at advanced stages and therefore early detection is important. The Oman Cancer Association (OCA) initiated a mobile mammography program in 2009, but no studies have evaluated its impact. This study aimed at estimating the proportion and predictors of OCA-screened women who had repeated mammography (adherence) and the sensitivity and specificity of the program. Demographic, screening, diagnosis, and treatment data of 13,079 women screened in the OCA mammography clinic from 2009 to 2016, and medical records of all breast cancer patients seen at Royal and Sultan Qaboos University hospitals during the same period were retrieved. Logistic regression analysis was conducted to identify predictors of adherence. A total of 8278 screened women over age 42 years (median age of 50 ± 8 years) were included in the study. Only 18% of initially negative screened women were compliant with recommended subsequent screening. Predictors of adherence included age (50-69 years), family history of cancer, family history of breast cancer, and breast self-examination. The overall cancer detection rate was 4.1/1000 screened women. Positive predictive value of screening was 4.7% with a sensitivity rate of 53% and specificity of 92%. This study showed a low mammography adherence among previously screened women. The study revealed low sensitivity, high specificity, and an acceptable cancer detection rate. Future programs should focus on improving data collection of screened women, maintaining the linkage of databases of screening and treatment clinics, and developing guidelines for breast cancer screening in Oman. The recommendations based on the study results should be incorporated into future professional, patient, and public cancer education programs.

Update on road traffic crashes: progress in the Middle East.

Road traffic injuries comprise the major share of all injuries globally. Traffic injuries kill 1.2 million people annually and injure 40 times as many, leaving a subsequent number totally disabled. Globally we spend approximately US $500 billion annually. The Middle East encompasses West Asia and North Africa and is very diverse economically, culturally and socially. Prevention and management of road traffic crashes and injuries is difficult. Comparative data are not readily available and therefore developing unified policies is a mammoth task. Implementation of best practices is not uniformly advocated due to socioeconomic and cultural differences. Enforcement of endorsed legislation on road traffic safety is not uniform in the region. Professional staff to combat this pandemic are scarce and it is important that capacity building, knowledge sharing, and increased political will becomes a priority in the region. This paper discusses the problems encountered in the prevention and management of road traffic injuries from the site of injury to rehabilitation and social reintegration. The role of Oman and that of the Bone and Joint Decade in the United Nations on Global Road Safety and its update is highlighted.