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

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.