Editorial: Alarming rise in breast cancer cases in India
Limited screening, lack of awareness and unequal access to healthcare continue to worsen survival rates, posing a major public health challenge
Every four minutes, a woman is diagnosed with breast cancer in India. Although highly treatable when diagnosed early, breast cancer cases have been on the rise at an alarming rate. The growing cancer burden is the result of several underlying factors, including lack of awareness, lifestyle changes, economic barriers and delayed diagnosis. Compared with Western nations, India has significantly poorer breast cancer survival rates. The latest data published by The Lancet Oncology presents a grim picture. The incidence of breast cancer in India has more than doubled over the past three decades. It is now the most commonly diagnosed cancer affecting Indian women. The age-standardised incidence of breast cancer has increased from 13 cases per 1 lakh women in 1990 to 29.4 per 1 lakh in 2023. The mortality rate has also gone up significantly, from 8.9 to 15.5 per 1 lakh women, marking a 74% increase. The data highlight a massive public health challenge. Unfortunately, over 60% of breast cancer patients in India are identified at stage III or IV of the illness. The general ignorance of women about breast cancer, its symptoms, and the value of regular screenings is a significant obstacle to the early identification of the disease. Numerous studies have shown that poverty, low educational attainment, lack of awareness, living in remote and inaccessible places, and having insufficient access to care are all linked to late-stage breast cancer diagnosis. Diagnosing the disease at an advanced stage seriously limits the treatment options and reduces survival rates.
In many parts of the country, talking about breast cancer is an uncomfortable conversation for women. Cultural taboos discourage them from discussing breast-related health issues with family. For some, the thought of a physical examination feels embarrassing, while others fear surgery, which discourages them from seeking care. In many cases, by the time symptoms appear, the cancer would have already spread. Awareness is more than educating about breast cancer; It is about helping women overcome hesitation. Another big challenge is the acute shortage of oncologists in the country. Moreover, nearly 95% of them are concentrated in urban areas, leaving rural populations underserved. India also lacks specialist treatment facilities and sufficient mammography equipment. India’s rising breast cancer rate mandates quick, multifaceted solutions. National screening programmes and community awareness drives are crucial for early detection. Equally important is equipping medical professionals with the knowledge and skills to address the issue. In rich countries, widespread screening and public awareness have helped stabilise mortality rates. India’s challenge is to replicate those gains in a health system that serves a vast and diverse population with limited resources. Data from the National Family Health Survey (NFHS-5) and Longitudinal Ageing Study in India (LASI Wave 1) show that only 1.3% of women aged 45 years and above have undergone mammography. Many women seek medical attention only when the disease has progressed considerably.
