Breast cancer remains a significant public health challenge in Colombia, with the Valle del Cauca region, including the city of Cali, disproportionately affected. To address this challenge, Cali has spearheaded a comprehensive initiative to strengthen breast cancer diagnosis across the region.
Since becoming the first city to join the City Cancer Challenge Foundation (C/Can) in 2017, Cali has made significant strides in cancer care. Strong government support, a comprehensive Population-Based Cancer Registry, engaged local stakeholders, and a sustainability partnership with ProPacifico, have been cornerstones to its progress.
Addressing breast cancer diagnostics fragmentation
A key part of Cali’s cancer control efforts is a project aimed at developing a more efficient and patient-centric breast cancer diagnostics pathway for the city and its surrounding region.
In 2021, the Valle de Cauca region faced a critical public health challenge,
says Dr. Carolina Wiesner, Director of the Colombian National Cancer Institute.
The region’s breast cancer mortality rates were the second-highest in Colombia and demanded special attention.
Recognising the need for a coordinated approach to breast cancer diagnosis, Cali with the support of Siemens Healthineers, launched the Breast Cancer Diagnostics Coordination project in 2023. Aligned with the Global Breast Cancer Initiative (GBCI) and the Ministry of Health’s National Cancer Intervention Plan, the goals of the project are to:
- Reduce time between mammography and biopsy
- Create a coordinated mechanism to follow women through diagnosis
- Ensure a more responsive system that identifies women with irregular mammograms and tracks them through to diagnosis confirmation and treatment initiation.
Multi-stakeholder collaboration for impact
A broad coalition, including C/Can, ProPacifico, and strategic partners such as the National Cancer Institute, both Secretaries of Health—the Secretary of Health of Valle del Cauca and the Secretary of Health of Cali—primary, secondary, and tertiary providers and payers, has united behind the initiative. The project’s initial network covers 70% of the population, impacting an initial cohort of 196,000 women.
Early project data reveals significant gaps in care that were previously unreported or not measured at the country level:
- Less than 30% (58,000) of women from the initial cohort had a mammogram or ultrasound within the last two years.
- Of the women who received their mammography or echocardiogram results, less than 1% (315) reported undergoing a biopsy (Birads 4 or 5).
- While National indicators report an average wait time of 44.7 days from symptoms to biopsy results, project data exposes the reality for women who actually require it: 41% of women who needed a biopsy are unable to access it, experiencing delays of up to 240 days.
These statistics underscore the critical importance of this project’s efforts to optimise access to breast cancer diagnosis.
Building a more efficient, sustainable system
To address these challenges, a multi-stakeholder, multi-pronged approach is being implemented. A tripartite committee, led by the Secretary of Health, and including payers and providers, was established to collaboratively work to streamline administrative processes and ensure that all women requiring a biopsy can access it within 30-days, as defined by Colombian law. The committee, supported by the project team, is also developing software to integrate and unify the various and disparate data sources into an easily accessible dashboard that can be used by all relevant stakeholders, including primary mammography clinics, pathology laboratories, cancer management professionals, payers, and local government.
Accessible, up-to-date, and shareable health data is crucial. However, challenges persist due to restrictive personal data sharing policies, non-interoperable systems used by providers and payers, and the high costs of developing and maintaining an independent homegrown system.
Both the Secretaries of Health at regional and city level recognise the importance of an interoperable data management system to improve information sharing and decision-making,
says Dr German Escobar, Secretary of Health of Cali.
We have prioritised the need and look forward to launching a centralised dashboard that enables city and regional follow-up of breast cancer patients.
By implementing these strategies, the Breast Cancer Diagnostics Coordination project is transforming how women access the diagnosis and care they need. Through a multi-sectoral approach and locally-led solutions driven by data and digital health technologies, this initiative is ensuring better patient outcomes and a healthier future for women in Cali and the region.
