Abstract 19: Geospatial Analysis and Impact of Targeted Development of Breast Cancer Care in The Gambia: A Cross-Sectional Study

Purpose: To characterize the capacity of healthcare facilities to provide breast cancer care in The Gambia and calculate the proportion of the population with access to services. Methods: A facility-based service assessment tool was administered to all healthcare facilities in The Gambia. Proximity of service availability and population analysis were assessed using GPS coordinates and LandScan population density raster. Distance thresholds of 10km, 25km, and 45km were established to determine access to screening services, pathologic diagnosis, and surgical management, respectively. An additional population analysis was performed to observe the potential impact of targeted resource development. Results: All 102 healthcare facilities were included. Breast cancer screening was mainly performed through clinical breast examination and was available in 52 facilities. Seven facilities provided pathologic diagnosis and surgical management of breast cancer. The proportion of the Gambian population with access to screening, pathologic diagnosis and surgical management was 72%, 57%, and 62%, respectively. Patients living on the eastern side of the country have to travel up to 35 km for screening services and up to 300 km for pathologic diagnosis and surgical management. Widespread implementation of clinical breast examination for screening, and targeted expansion of diagnostic and surgical resources in two hospitals would increase the covered population to 95%, 67%, and 84%. This would decrease the maximum distance to access breast cancer care to 15 km for screening and 90 km for diagnosis and surgical management. Conclusion: Almost half of the Gambian population do not have access to pathologic diagnosis and surgical management of breast cancer within a reasonable travel distance, and all facilities offering these services are located in the capital city. Mapping and population analysis can identify key areas of need. This approach allows targeted development of resources to significantly increase access to breast cancer care in a low resource setting. Citation Format: Fidel Lopez-Verdugo, Meghan Mali, Moustafa Moustafa, Jonathan Nellermoe, Justin Sorensen, Mustapha Bittaye, Ramou Njie, Yankuba Singhateh, Alison Goldsmith, Nuredin I. Mohammed, Raymond R. Price, Edward Sutherland, Ousman Sanyang. Geospatial Analysis and Impact of Targeted Development of Breast Cancer Care in The Gambia: A Cross-Sectional Study [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 19.