Sunday, March 17, 2013

India - Late Cancer Diagnosis Linked To Low Survival Rates In Rural India

Women in developed countries survive roughly a decade longer after a breast cancer diagnosis compared to women in poor-to-middle-income countries, says a new study.

Approximately 1 in 22 women in India are expected to develop breast cancer, a statistic that has been steadily increasing over time.

But this is only the tip of the iceberg, say researchers from the University of Michigan in the United States, who showed that women in developed countries survive roughly ten years longer after a breast cancer diagnosis compared to women in poor-to-middle-income countries.

The researchers conducted a study on nearly 300 women in the southern rural district of Udupi, India. Depending on the patient’s stage of cancer, they were treated with one of three possible drug treatments.

Only 27 percent of patients were diagnosed in the early stages of cancer, and after their diagnosis they survived an average of 11 years with treatment. The majority of patients, however, were diagnosed in the later stages of cancer, and subsequently survived only 1 to 2.5 years with treatment.

While the breast cancer rate is much higher in the United States at 1 in 8 women, the survival rate is also much higher. For instance, the five-year survival rate for Indian women is about 60 percent; in developed countries, it is 79 to 85 percent.

In India, many diagnoses occur at later stages because screening is not available in those rural areas, says the study’s principal investigator, Rajesh Balkrishnan, an associate professor at U-M schools of Pharmacy and Public Health.

Fear, poverty, and ignorance about breast cancer also delay treatment and diagnosis. And, if the diagnosis does come early, access and use of breast cancer chemotherapy treatments – even the generic inexpensive options – are not readily available. Only the latest stage patients receive the most current and expensive treatments, says Balkrishnan.

In contrast, women in developed countries have access to earlier screening, leading to early detection of breast cancer, and better access to good health care, which translates into patients adhering to their chemotherapy treatment plans and higher survival rates.

Balkrishnan noted that early diagnosis paired with continued treatment is key to ensuring patient survival.

“I think if the tumor is diagnosed early and treated aggressively, a patient can expect an additional decade of survival,” he said. “But access and adherence to optimal treatment remains very difficult for women in poorer countries.”

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