SEATTLE — Breast cancer is the most common form of cancer among women worldwide, affecting one in eight women throughout their lifetime. It is also a leading cause of death among women, specifically in low- and middle- income countries; this is largely due to the lack of preventative measures and education available to women in these areas. Currently, almost 70 percent of all breast cancer deaths occur in developing countries, which are often underfunded in research and ill-prepared in treatment resources. Asia currently has the highest rate of breast cancer deaths, followed by Africa and finally North America.
Prevention of Breast Cancer in Developing Countries
While there are few explicit preventative measures to take against breast cancer, there are ways to minimize certain risk factors or be more prepared to catch it early and handle it effectively. Lifestyle factors including consuming alcohol, being overweight or obese, or not engaging in physical activity account for 21 percent of breast cancer deaths worldwide.
Being tested for the related mutations, including BRCA1 and BRCA2, are effective ways to stay ahead of a diagnosis and be active in breast cancer prevention. However, lack of screening availability or attendance is a huge factor contributing to the high rates of breast cancer deaths in developing countries; because these services are very expensive and often unavailable to low-income women, it makes early detection of breast cancer a rarity in developing countries.
Diagnosing Breast Cancer in Developing Countries
Of course, there are several reasons that rates of diagnosis are far lower in developing countries. A lack of funding plays a huge role in late diagnoses. In addition, despite the high prevalence of breast cancer deaths in under-developed countries, currently, only 5 percent of global cancer spend is delegated to these underfunded areas. Proper screening is crucial to maintaining low rates of breast cancer deaths in low- and middle- income countries; with consistently enforced and effectively provided screening comes early detection but is very costly to implement.
Diagnosing breast cancer in developing countries becomes increasingly challenging, with obstacles including getting women to attend screenings, overcoming the stigma that comes with having breast cancer in these areas and a lack of sufficient resources.
Another significant problem presented in diagnosing breast cancer in low-income areas is the stage at presentation coupled with the lack of treatment centers. When women wait too long to get screened and find their cancer in later stages, treatment needs to be more timely and some developing countries do not have adequate resources to address these needs.
Treating Breast Cancer in Developing Countries
Due to varying levels of access to treatment and prevention, breast cancer survival rates vary country to country. In high-income areas, such as North America and Sweden, survival rates are as high as 80 percent. However, the survival rate can dip to below 40 percent in low-income countries, mainly as a result of late-detection. When performed effectively and consistently, mammogram screening can reduce breast cancer mortality by 30 to 40 percent. Encouraging better education and more available screening resources would be a huge step towards closing the gap between breast cancer in developing countries and developed countries.
What Can Be Done?
Many developing countries have turned to Clinical Breast Examinations (CBE) as a cost-effective approach to breast cancer screening. Research has shown that in India, which is the largest developing country, CBE compares favorably to mammography in developed countries, in terms of cost-effectiveness. The World Health Organization (WHO) promotes comprehensive cancer control programs that include prevention, early detection, diagnosis and treatment, as well as steps to take towards rehabilitation. Developing countries must implement programs that acknowledge and address this public health problem, efficiently and effectively. Widespread education and awareness could be key to this.
If given the proper resources and education, women in developing countries could better and more effectively deal with this tragic illness that affects women worldwide, regardless of socioeconomic status.
– Charlotte M. Kriftcher