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BEYOND CHEMO AND CLINICAL TRIALS

By Sara Danial
Tue, 02, 24

The incidence of breast cancer among women under the age of 40 has risen at an alarming rate in India, Pakistan, Bangladesh, Sri Lanka, and Nepal…

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Breast cancer, a pervasive global health concern, is increasingly making its presence felt among young women in the subcontinent. While traditionally perceived as a disease affecting older age groups, recent trends point to a disturbing rise in breast cancer cases among women in their prime. This demographic shift raises critical questions about the factors contributing to this surge and underscores the need for heightened awareness and proactive measures. This article delves into the complex landscape of women’s health in South Asian countries, exploring the key reasons behind the growing incidence of breast cancer among young women.

Breast cancer is the most common cancer among women globally, but its impact in South Asia has seen a significant shift in recent years. According to data from the World Health Organization (WHO), the incidence of breast cancer among women under the age of 40 has risen at an alarming rate in countries like India, Pakistan, Bangladesh, Sri Lanka, and Nepal. While genetic predisposition and familial history are acknowledged risk factors, other elements unique to the subcontinent contribute to this surge.

Late detection and limited awareness:

One major hurdle contributing to the rise of breast cancer cases in South Asia is the late detection of the fatal disease. Limited awareness about breast health, screening, and the importance of early detection often results in delayed diagnosis and advanced stages of cancer at the time of detection. Cultural stigmas and misconceptions surrounding breast cancer screenings contribute to a lack of regular check-ups among young women.

For instance, a study conducted by the Indian Journal of Cancer highlighted that a significant percentage of breast cancer cases in India are diagnosed at an advanced stage, limiting treatment options and reducing overall survival rates. Similar trends have also been observed in Pakistan and Bangladesh, where cultural norms and societal taboos discourage open discussions about breast health, hindering timely intervention.

Changing lifestyle factors:

The adoption of Westernised lifestyles and dietary habits is another crucial factor contributing to the rise of breast cancer among young women in the subcontinent. Urbanisation has led to increased sedentary lifestyles, higher consumption of processed foods, and a decline in physical activity. These lifestyle changes are associated with an increased risk of breast cancer, as evidenced by numerous studies.

In a survey conducted by the National Institute of Cancer Prevention and Research in India, the link between obesity and breast cancer was established, particularly in younger age groups. Similar findings have been reported in Sri Lanka and Nepal, emphasising the need for targeted public health campaigns to promote healthy lifestyles and dietary choices among young women.

Environmental factors and pollution:

The subcontinent grapples with severe environmental pollution, and emerging research suggests a possible link between environmental factors and the rising incidence of breast cancer. Air and water pollution, coupled with exposure to harmful chemicals, may contribute to genetic mutations that increase the risk of breast cancer.

Studies carried out in major South Asian cities, including New Delhi, Karachi, and Dhaka, have identified higher levels of pollutants and carcinogens in the environment. The long-term impact of such exposure on breast cancer incidence among young women is an area of growing concern and warrants comprehensive research to establish definitive connections.

Genetic predisposition:

While genetic factors have always played a role in breast cancer, South Asian countries are witnessing an increase in hereditary cases. The prevalence of specific genetic mutations, such as BRCA1 and BRCA2, is being studied in various populations across the subcontinent.

In a ground-breaking study in Pakistan, researchers found a higher prevalence of BRCA1 and BRCA2 mutations among young breast cancer patients. This genetic predisposition, coupled with other environmental and lifestyle factors, may contribute to the early onset of breast cancer in South Asian women.

The role of healthcare infrastructure:

The accessibility and quality of healthcare infrastructure in South Asian countries also impact the incidence and outcomes of breast cancer cases. Limited resources, particularly in rural areas, lead to delayed diagnosis, inadequate treatment options, and poor follow-up care.

In a comparative analysis of breast cancer outcomes in urban and rural areas of Bangladesh, disparities in survival rates were evident. Improving healthcare infrastructure, increasing awareness, and providing affordable and accessible screening facilities are critical steps in addressing the rising tide of breast cancer in the subcontinent.

The increasing prevalence of breast cancer among young women in South Asia is a multifaceted challenge that demands urgent attention. Late detection, limited awareness, changing lifestyle factors, environmental pollution, genetic predisposition, and healthcare infrastructure all play integral roles in shaping this alarming trend. To curb this rise, concerted efforts are required at the individual, community, and policy levels.

Governments and healthcare authorities in South Asian countries must prioritise the implementation of comprehensive breast cancer awareness and screening programmes. Educational initiatives to dispel cultural taboos and promote regular check-ups should be at the forefront. Additionally, addressing lifestyle factors and environmental concerns and improving healthcare infrastructure are pivotal in creating a holistic approach to combating breast cancer among young women in the subcontinent. Beyond chemotherapy and clinical trials, only through collaborative efforts can South Asian countries hope to reverse this concerning trend and safeguard the health and well-being of their future generations.

Sara Danial is a Pakistan-based writer and editor who can be reached at sara.amj@hotmail.co.uk

This article was originally published in a recent issue of SouthAsia Magazine.