Background
Breast cancer is prevalent cancer among Libyan women. Alarmingly, almost two-thirds of Libyan breast cancer patients present at advanced stages, making breast cancer the leading cause of cancer-related mortality among women in the country. The lack of a-population-based organized early detection program is a major threat to public health.
National Cancer Institute Misurata is one of the major cancer care in Libya, and it covering an estimated 13% of the Libyan population. In 2023, NCI Misurata launched a capacity-building initiative that trained 46 master trainers in breast cancer early detection at four polyclinics in Misurata. Building on this institutional infrastructure and workforce development, the present study represents, to our knowledge, the first implementation pilot in Libya focused on breast cancer early detection and prevention within a primary health care setting.
Aim
To assess the feasibility, acceptability, and challenges of implementing breast cancer early detection through routine primary health care services in Libya.
Methods
This pilot project is conducted in Misurata, Libya's third-largest and most stable city. Five healthcare facilities were included as implementation sites. The study targets 5,000 women aged 40 to 69 years who live in the target areas. The study will take 38 months and consists of three phases: preparation (12 months), implementation (18 months), and evaluation (8 months). Data are collected using two standardized questionnaires, one used at the healthcare facilities, and the other used at breast clinic at NCI Misurata.  Data was entered into the District Health Information Software 2. During the preparation phase, healthcare staff were trained and breast clinics were established within participating facilities. The intervention included training primary healthcare providers in clinical breast examination, breast health awareness, basic communication skills, and standardized referral pathways to the breast clinic of NCI Misurata.
Ethical approval obtained from the Libyan Ministry of Health, the National Cancer Control Authority, and the Ethics Committee of the National Cancer Institute (NCI) Misurata. Written informed consent obtained from all participants.
Preliminary Results
Within four months of the implementation phase, women were invited to participate in the breast cancer early detection program by various media channels. There were 364 women attended and underwent clinical breast examination. Among the women examined, 198 (54.4%) screened positive then referred to the breast clinic at NCI Misurata for further clinical evaluation. Finally, only 92 women visited the NCI Misurata's clinic, and 73 women (79.3%) received mammography/ultrasound and biopsy if needed. Six women diagnosed with breast cancer, five of them were found to be in early stages: one case at stage I, and four at stage II. Additionally, one case recognized at stage III.
Conclusion
Preliminary results indicate that implementing breast cancer early detection into primary health care in Libya helped in effective identification of five early-stage cancers. This pilot will offer essential information to guide national cancer control policies and supports the possible scale up of early detection programs in similar resource-constrained contexts.