What's Driving Surge in Breast Cancer?

Late-stage diagnosis is a major issue, with over 75 per cent of cases being detected at advanced stages (50 per cent at Stage 3 and 25 per cent at Stage 4).
This significantly reduces survival rates.

Experts have raised concern over the increase in incidence rate and mortality due to breast cancer in India, citing lifestyle issues and lack of screening mechanism behind the rising caseload.

This comes as government data states that incidence and mortality rates due to breast cancer have been incrementally increasing in India.

According to National Cancer Registry Program data cited by the ministry of health and family welfare in a parliamentary response this year, while the estimated rate of incidence increased from 200,218 cases in 2019 to 221,579 cases in 2023, the mortality increased from 74,481 to 82,429 at the same time.

The data also suggests that states such as Uttar Pradesh, Maharashtra and West Bengal had the highest incidences of breast cancer in 2023.

Commenting on the reasons why India is seeing a high incidence of breast cancer, Dr Pankaj Goyal, senior consultant, medical oncology, Rajiv Gandhi Cancer Institute and Research Centre said urbanisation, sedentary lifestyles, and rising stress levels are significantly contributing to an increase in health issues, including cancer.

"Environmental factors also play a crucial role; the presence of artificial hormones in food, especially dairy products, along with exposure to pesticides and pollutants, can alter genetic predispositions and elevate cancer risks," he added.

Dr Mandeep Singh Malhotra, director of surgical oncology at the C K Birla Hospital, Delhi, said genetic predisposition also plays a role.

Around 15 to 24 per cent of cases are potentially linked to hereditary factors, which often lead to early onset and aggressive cancers in younger women, he added.

While a high percentage of breast cancer patients in India are in the pre-menopausal age group, or 45 to 55 years, doctors are now flagging the disease's occurrence in younger women as well.

Experts suggest that increasing lifestyle changes in urban centres is leading to younger women getting the disease. And, lower screening rates are leading to potential patients finding about the diagnosis at a later stage of the cancer.

"Many girls are now experiencing menarche at younger ages, leading to higher lifetime oestrogen exposure, which increases cancer risk.

"Additionally, delayed pregnancies, opting not to have children and reduced breastfeeding duration reduce natural protective factors," Dr Malhotra said.

Late-stage diagnosis is a major issue, Dr Malhotra added, with over 75 per cent of cases being detected at advanced stages (50 per cent at Stage 3 and 25 per cent at Stage 4). This significantly reduces survival rates.

Flagging the lack of awareness and formal screening programmes in India, Dr Devavrat Arya, senior director medical oncology at the Max Med Centre, Lajpat Nagar, Delhi, said patients often overlook or ignore the typical symptoms of breast cancer that include lump in breast, leading to high mortality rates.

"This means that cancers are being diagnosed at a higher stage, necessitating more treatment and greater possibility of needing chemotherapy, radiation, hormone or targeted therapy," he said.

Many patients, especially in rural areas, also hesitate to discuss their concerns with family members. This leads them to seek medical help only when symptoms become severe.

"Contributing factors to this delay include embarrassment, financial constraints, and limited access to healthcare facilities," Dr Goyal said.

Feature Presentation: Ashish Narsale/Rediff.com