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Breast
                Cancer in
                India




Narjis Sayeed
Breast cancer is a major health
problem worldwide
   According to WHO:
    A woman dies of breast cancer
     somewhere in the world every minute;
    Breast cancer is the most common
     malignancy among women worldwide;
    Breast cancer is thought to be due to
     genetic, lifestyle, and environmental
     causes; the latter two are subject to
     change.
Stages of Breast Cancer
   Stage 0: Non-invasive breast cancer, no indication of the
    cancer or cancerous cells breaking out from origin point
   Stage 1: Invasive breast cancer, the cancerous cells are
    breaking through to or invading surrounding normal
    tissue
   Stage 2: 2a No tumor but there are cancerous cells in the
    lymph nodes, or there is a tumor that has grown.
   Stage 2: 2b Cancerous cells in the lymph nodes and /or
    tumor has grown.
   Stage 3: Cancer has spread to lymph nodes near
    breastbone and chest wall
   Stage 4: Cancer has spread (metastasized) to other parts
    of the body.
Facts
 Incidence of breast cancer in India has
  increased among women in their 30s and 40s
  compared to older women, and they are
  being diagnosed at later stages
 Cancer has become more aggressive in
  younger woman than older woman,
  advancing through the stages faster.
 Breast cancer cases have been increasing in
  India in the past decade, due to increase of
  urbanization.
 Risk increases as a woman has her first child
  after turning 30.
Incident of breast cancer in India

 According to the Times of India, as of last year
  the rate of breast cancer in India was 11.1 (per
  100,000 for age standardized mortality rate), and
  the number of deaths was 53,592.
 Incident number of breast cancer rates in 2001
  and 2016 national levels respectively: 89,914
  140,975
Breast Cancer in Andhra Pradesh
 Breast cancer is the most common type of
  cancer in many cities and the second most
  common in rural areas.
 Andhra Pradesh was the fifth highest state
  with deaths due to breast cancer, with
  3863 deaths in the year 2010.
 Rates of young women being diagnosed is
  increasing in Andhra Pradesh
Trend of Breast Cancer among
different age groups in India in 2008
and 25 years back
Breast Cancer in India is considered to
be a “Western Disease”
   “Women in high-income countries like the
    United States and the United Kingdom are
    benefiting from early cancer screenings, drug
    therapies, and vaccines,” said Dr. Rafael
    Lozano, Professor of Global Health at IHME
    [Institute of Health Metrics and Evaluation]
    and one of the co-authors of the Lancet study,
    “We are seeing the burden of breast and
    cervical cancer shifting to low-income
    countries in Africa and Asia. This is the one of
    the early signs of the emerging threat of non
    communicable diseases in these countries.”
Some steps have been taken
   Statewide Breast Cancer
    Awareness Month to promote
    screening
   Breast Cancer screening
    initiative: 5000 health
    workers trained by the State
    of Andhra Pradesh to perform
    clinical breast examinations
   Breast Cancer screening
    program in Gandhi Medical
    Hospital/College, Hyderabad,
    AP, began in April 2006 and
    ended on February 2007
Gandhi Medical Hospital/College Program
   Biggest government hospital in state of Andhra Pradesh
   Breast Cancer Screening Program in the Women’s Clinic
    from April 2006 to February 2007
   Hospital and clinic staff were trained according to WHO
    guidelines
   Conducted screenings and awareness programs in the
    hospital and clinics of the hospital
   All women who came to the Women’s Clinic were
    screened; screenings were not conducted in other areas
    of hospital or clinics;
   171 completed screenings were considered adequate
   Of these, 26 showed malignancy, according to the
    findings of this program.
Policy Proposal
 As of 2011 there are no policies regarding
  breast cancer.
 I propose three policy action changes:
1.    Doctors are required to inform their female patients
     about the option and need of breast cancer
     screening.
2.   Data concerning breast cancer diagnoses and
     screening should be collected for current and future
     use.
3.   A certain amount of health care funding will be used
     for education programs and breast cancer
     screening; and financial support will be provided to
     those unable to have a breast screening done.
Policy Paramours in the House of
the People
 Shri Sukender Reddy Gutha- for
  providing better health care for people
  in rural areas.
 Shri Madhu Goud Yaskhi- founded the
  Madhu Yaskhi foundation, part of
  which is providing funding to private
  health care facilities in rural areas.
 Smt. Meira Kumar - held a position on
  the committee for education and
  health programs for women.
Policy Paramours in the Council of
States
 Shri Raashid Alvi (Member of
  Parliament)- for equitable access to
  health services
 Shri Y.S. Chowdary (Member of
  Parliament)- Rise in cases of diseases
  afflicting the young female population,
  breast cancer included.
 Dr. T. Subbarami Reddy (Member of
  Parliament)- investment in health
  education
Stakeholders
 Government of        Cancer foundation
  Andhra Pradesh        of India
 Family, Welfare,     CPAA (Cancer
  Health department     Patients Aid
  of Hyderabad          Association)
 World Health         Passages
  Organization         Ushalakshmi
                        Breast Cancer
                        Foundation
Reference
   ChartsBin,com, viewed on 25th September, 2011, http://chartbin.com/view/252
   Breastcancerindia.net
   India.gov.in
   Shrivastav, Snehlata. "Spike in Cancer Cases Alarms Experts - Times Of
    India." Featured Articles From The Times Of India. 16 Sept. 2011. Web. 21 Sept.
    2011. <http://articles.timesofindia.indiatimes.com/2011-09-
    16/nagpur/30165128_1_cancer-registries-cervical-cancer-breast-cancer>.
   Shukla, Shobha. "Cervical and Breast Cancers: Killers On The Prowl | Scoop
    News." Scoop - New Zealand News. 16 Sept. 2011. Web. 25 Sept. 2011.
    <http://www.scoop.co.nz/stories/HL1109/S00142/cervical-and-breast-cancers-
    killers-on-the-prowl.htm>.
   Murthy, NS, Kishore Chaudhry, and GK Rath. "Burden of Cancer and Projections for
    2016, Indian Scenario: Gaps in the Availability of Radiotherapy Treatment
    Facilitie." Asian Pacific Journal of Cancer Prevention 9 (2008): 671-77. Web.
   http://www.breastcancer.org/symptoms/diagnosis/staging.jsp
   ORAL, BREAST AND CERVICAL CANCERS SCREENING IN GANDHI MEDICAL
    COLLEGE/HOSPITAL SECUNDERABAD. Rep. Hyderabad, 2007. World Health
    Orginazation. Web.
    <http://http://www.whoindia.org/LinkFiles/Cancer_report_hyderabad.pdf>

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Breast Cancer in India: A Growing Epidemic

  • 1. Breast Cancer in India Narjis Sayeed
  • 2. Breast cancer is a major health problem worldwide  According to WHO: A woman dies of breast cancer somewhere in the world every minute; Breast cancer is the most common malignancy among women worldwide; Breast cancer is thought to be due to genetic, lifestyle, and environmental causes; the latter two are subject to change.
  • 3. Stages of Breast Cancer  Stage 0: Non-invasive breast cancer, no indication of the cancer or cancerous cells breaking out from origin point  Stage 1: Invasive breast cancer, the cancerous cells are breaking through to or invading surrounding normal tissue  Stage 2: 2a No tumor but there are cancerous cells in the lymph nodes, or there is a tumor that has grown.  Stage 2: 2b Cancerous cells in the lymph nodes and /or tumor has grown.  Stage 3: Cancer has spread to lymph nodes near breastbone and chest wall  Stage 4: Cancer has spread (metastasized) to other parts of the body.
  • 4. Facts  Incidence of breast cancer in India has increased among women in their 30s and 40s compared to older women, and they are being diagnosed at later stages  Cancer has become more aggressive in younger woman than older woman, advancing through the stages faster.  Breast cancer cases have been increasing in India in the past decade, due to increase of urbanization.  Risk increases as a woman has her first child after turning 30.
  • 5. Incident of breast cancer in India  According to the Times of India, as of last year the rate of breast cancer in India was 11.1 (per 100,000 for age standardized mortality rate), and the number of deaths was 53,592.  Incident number of breast cancer rates in 2001 and 2016 national levels respectively: 89,914 140,975
  • 6. Breast Cancer in Andhra Pradesh  Breast cancer is the most common type of cancer in many cities and the second most common in rural areas.  Andhra Pradesh was the fifth highest state with deaths due to breast cancer, with 3863 deaths in the year 2010.  Rates of young women being diagnosed is increasing in Andhra Pradesh
  • 7. Trend of Breast Cancer among different age groups in India in 2008 and 25 years back
  • 8. Breast Cancer in India is considered to be a “Western Disease”  “Women in high-income countries like the United States and the United Kingdom are benefiting from early cancer screenings, drug therapies, and vaccines,” said Dr. Rafael Lozano, Professor of Global Health at IHME [Institute of Health Metrics and Evaluation] and one of the co-authors of the Lancet study, “We are seeing the burden of breast and cervical cancer shifting to low-income countries in Africa and Asia. This is the one of the early signs of the emerging threat of non communicable diseases in these countries.”
  • 9. Some steps have been taken  Statewide Breast Cancer Awareness Month to promote screening  Breast Cancer screening initiative: 5000 health workers trained by the State of Andhra Pradesh to perform clinical breast examinations  Breast Cancer screening program in Gandhi Medical Hospital/College, Hyderabad, AP, began in April 2006 and ended on February 2007
  • 10. Gandhi Medical Hospital/College Program  Biggest government hospital in state of Andhra Pradesh  Breast Cancer Screening Program in the Women’s Clinic from April 2006 to February 2007  Hospital and clinic staff were trained according to WHO guidelines  Conducted screenings and awareness programs in the hospital and clinics of the hospital  All women who came to the Women’s Clinic were screened; screenings were not conducted in other areas of hospital or clinics;  171 completed screenings were considered adequate  Of these, 26 showed malignancy, according to the findings of this program.
  • 11. Policy Proposal  As of 2011 there are no policies regarding breast cancer.  I propose three policy action changes: 1. Doctors are required to inform their female patients about the option and need of breast cancer screening. 2. Data concerning breast cancer diagnoses and screening should be collected for current and future use. 3. A certain amount of health care funding will be used for education programs and breast cancer screening; and financial support will be provided to those unable to have a breast screening done.
  • 12. Policy Paramours in the House of the People  Shri Sukender Reddy Gutha- for providing better health care for people in rural areas.  Shri Madhu Goud Yaskhi- founded the Madhu Yaskhi foundation, part of which is providing funding to private health care facilities in rural areas.  Smt. Meira Kumar - held a position on the committee for education and health programs for women.
  • 13. Policy Paramours in the Council of States  Shri Raashid Alvi (Member of Parliament)- for equitable access to health services  Shri Y.S. Chowdary (Member of Parliament)- Rise in cases of diseases afflicting the young female population, breast cancer included.  Dr. T. Subbarami Reddy (Member of Parliament)- investment in health education
  • 14. Stakeholders  Government of  Cancer foundation Andhra Pradesh of India  Family, Welfare,  CPAA (Cancer Health department Patients Aid of Hyderabad Association)  World Health  Passages Organization  Ushalakshmi Breast Cancer Foundation
  • 15. Reference  ChartsBin,com, viewed on 25th September, 2011, http://chartbin.com/view/252  Breastcancerindia.net  India.gov.in  Shrivastav, Snehlata. "Spike in Cancer Cases Alarms Experts - Times Of India." Featured Articles From The Times Of India. 16 Sept. 2011. Web. 21 Sept. 2011. <http://articles.timesofindia.indiatimes.com/2011-09- 16/nagpur/30165128_1_cancer-registries-cervical-cancer-breast-cancer>.  Shukla, Shobha. "Cervical and Breast Cancers: Killers On The Prowl | Scoop News." Scoop - New Zealand News. 16 Sept. 2011. Web. 25 Sept. 2011. <http://www.scoop.co.nz/stories/HL1109/S00142/cervical-and-breast-cancers- killers-on-the-prowl.htm>.  Murthy, NS, Kishore Chaudhry, and GK Rath. "Burden of Cancer and Projections for 2016, Indian Scenario: Gaps in the Availability of Radiotherapy Treatment Facilitie." Asian Pacific Journal of Cancer Prevention 9 (2008): 671-77. Web.  http://www.breastcancer.org/symptoms/diagnosis/staging.jsp  ORAL, BREAST AND CERVICAL CANCERS SCREENING IN GANDHI MEDICAL COLLEGE/HOSPITAL SECUNDERABAD. Rep. Hyderabad, 2007. World Health Orginazation. Web. <http://http://www.whoindia.org/LinkFiles/Cancer_report_hyderabad.pdf>