Developing World Faces Breast Cancer Surge
Health Policy

Developing World Faces Breast Cancer Surge

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BBREAST Cancer

• Consumer awareness and cultural barriers surrounding screening puttinglives at risk
• 15 million years of ‘healthy life’ were lost worldwide in 2008 due to women dying early or being ill with the disease

Rising breast cancer incidence and mortality represent a significant and growing threat for the developing world, according to a new global study commissioned by GE Healthcare.

Explained report co-author BengtJönsson, Professor in Health Economics at the Stockholm School of Economics: “Breast cancer is on the rise across developing nations, mainly due tothe increase in life expectancy and lifestyle changes such as women having fewer children, as well as hormonal intervention such as post-menopausal hormonal therapy. In these regionsmortality rates arecompounded by the later stage at which the disease is diagnosed, as wellas limited access to treatment, presenting a ’ticking time bomb’ which health systems and policymakers in these countries need to work hard to defuse.”

The study confirms findings from various other studies done on growing incidences of breast cancer cases in India. Breast cancer is now the second most common cancer diagnosed in Indian women after cervical cancer. Studies have also shown that Indian women develop breast cancer rougly a decade earlier than women in Western countries. With an increasing number of younger women becoming susceptible to the disease, India faces a growing breast cancer epidemic. It is estimated that by 2030 the number of new cases of breast cancer in India will raise from current 115,000 to reach just under 200,000 per year3In common with other developing regions, mortality rates for breast cancer in India are high in comparison to incidence rates. Poor survival may be largely explained by lack of or limited access to early detection services and treatment.

The alarming number of breast cancer cases in India demands an immediate call for action. Commenting on the need for driving awareness of early detection of cancer, Terri Bresenham, President& CEO, GE Healthcare, South Asia said, “Breast cancer is one of the most deadliest diseases a woman has to battle and in India, the number of cases of breast cancer have increased by 10-15% over the last decade.Stage one detection increases chances of survival to 80% as compared to a Stage three detection where the chances are a mere 20%. The need of hour lies in creating awareness on early detection of cancer and shifting the fight from Stage four to Stage one. As a part of our commitment towards building a healthier India, GE is working towards improving access to affordable early detection technology solutions. We are also working towards building awareness and have recently launched the ‘#GECodePink’ campaign, a social media initiative to improve awareness on breast cancer. We want to reach out to as many women as possible and educate them by providing them with access to white papers, quick stats,factoids and tips on self examination.”

Need for better consumer education
The report on ‘the prevention, early detection and economic burden of breast cancer’suggests that consumer understanding about breast cancer and screening methods is putting lives at risk in the developing world. For example, a recent survey in Mexico City indicated many women feel uncomfortable or worried about having a mammogram.

A recent study by the Asian Pacific Journal of Cancer Prevention indicated that in the urban area of Delhi, only 56% women were aware of breast cancer; among them, 51% knew about at least one of the signs/symptoms, 53% were aware that breast cancer can be detected early, and only 35% mentioned about risk factors. In rural Kashmir only 4% of the women had received any training or education about the purpose and technique of breast self exam.

Commented Claire Goodliffe, Global Oncology Director for GE Healthcare:“It is of great concern that women in newly industrialized countries are reluctant to get checked out until it is too late. This is why GE is working with a number of governments and health ministries in these regions to expand access to screening and improve consumer awareness. Some of these initiatives are making excellent progress.

Recently, Wipro GE Healthcare and Maharashtra Government announced one of the largest Public Private Partnership to upgrade Government hospitals in Maharashtra. 22 district hospitals will be equipped with state-of-the-art mammography units to improve access to breast cancer screening and diagnosis.

Years of healthy life lost

The study draws some interesting conclusions about the impact of breast cancer on sufferers’ lives. According to the most recent published data,15 million years of ‘healthy life’ were lost worldwide in 2008due to women dying early or being ill with the disease .According to Globocandata, (International agency for Research on Cancer)India is on top of the table with 1.85 Million years of healthy life lost due to breast cancer.‘Healthly life lost’ is defined by years lost due to premature death and being incapacitated by the effects of breast cancer.

SaidBengtJönsson: “The report findings suggest that a worryingly high proportion of women are still dying from breast cancer across the world and this seems to correlate strongly with access to breast screening programs and expenditure on healthcare.”

He went on to highlight the distinct lack of accurate and current data on things like breast cancer incidence and mortality, the economic burden of the disease, and detailed patient-linked data on outcomes in relation to treatment patterns and stage of diagnosis. “This limits analyses of how changes in clinical practice affect patient outcomes and needs to be addressed”, he said.

As mortality falls, quality of life is an issue
As breast cancer incidence rates have steadily increased in developed countries over the last 50 years it is no surprise that the main focus of treatment has been survival. However as more women are now living with the disease, the report suggests that quality of life is becoming a growing issue as survival rates improve. As a result doctors are urged to focus on measuring the impact of diagnosis and treatment on survivors’ quality of life to identify what problems patients may have and how these can be mitigated.

Concluded Claire Goodliffe: “This report finds a direct link between survival rates in countries and the stage at which breast cancer is diagnosed. It provides further evidence of the need for early detection and treatment which we welcome given current controversies about the relative harms, benefits and cost effectiveness of breast cancer screening.”

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