Better Reporting and Awareness Campaigns Needed for Breast Cancer in Pakistani Women

Nazeer Hussain Khan, Shao-Feng Duan, Dong-Dong Wu, Xin-Ying Ji, Nazeer Hussain Khan, Shao-Feng Duan, Dong-Dong Wu, Xin-Ying Ji

Abstract

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer deaths in women globally. In 2018, 2.1 million new cases were reported, with 627,000 deaths. Pakistan has the highest incidence rate of breast cancer among Asian countries: one in every nine women has a lifetime risk of being diagnosed with breast cancer. By reason of many misconceptions about the etiology of the disease and socioeconomic factors, Pakistani women have very low rates of early detection and diagnose breast cancer at advance stages with fewer chances of survival. The key to cure the breast cancer is early diagnosis. The aim of current review is to highlight the factors leading to the delays in early presentation of breast cancer in Pakistani women and to summarize possible recommendations for educating women about early diagnosis along with palliative care facilities for patients suffering from breast cancer. Furthermore, this study appeals to both the general public and government in the belief that better reporting and awareness campaigns may bring more women to clinics for early diagnosis.

Keywords: Pakistani women; better reporting; awareness campaigns; breast cancer; health budget.

Conflict of interest statement

The authors hereby declare that they have no conflicts of interest to disclose.

© 2021 Khan et al.

Figures

Figure 1
Figure 1
Diagram of risk factors that lead to delay in early diagnosis of breast cancer in Pakistani women and recommendations to overcome these factors. There are both patient-level socioeconomic constraints and lack of advanced medical facilities in Pakistan’s health system holding back more women going to clinics for breast screening. Recommendations to address these factors include expanding the health budget and more awareness about breast cancer etiology with health education.

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
    1. Fitzmaurice C, Allen C, Barber RM, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524–548. doi:10.1001/jamaoncol.2016.5688
    1. Sohail S, Alam SN Breast cancer in Pakistan-awareness and early detection; 2007.
    1. Organization WH. The global cancer observatory. All cancers Source; 2019.
    1. Begum N. Breast cancer in Pakistan: a looming epidemic. J Coll Physicians Surg Pak. 2018;28(2):87–88. doi:10.29271/jcpsp.2018.02.87
    1. Society AC. Breast cancer early detection and diagnosis; 2020. Available from: . Accessed December4, 2020.
    1. Rivera-Franco MM, Leon-Rodriguez E. Delays in breast cancer detection and treatment in developing countries. Breast Cancer. 2018;12:1178223417752677.
    1. Sun YS, Zhao Z, Yang ZN, et al. Risk factors and preventions of breast cancer. Int J Biol Sci. 2017;13(11):1387–1397. doi:10.7150/ijbs.21635
    1. Rashid MU, Muhammad N, Naeemi H, et al. Spectrum and prevalence of BRCA1/2 germline mutations in Pakistani breast cancer patients: results from a large comprehensive study. Hered Cancer Clin Pract. 2019;17(1):27. doi:10.1186/s13053-019-0125-5
    1. Shamsi U, Khan S, Azam I, et al. A multicenter case control study of association of vitamin D with breast cancer among women in Karachi, Pakistan. PLoS One. 2020;15(1):e0225402.
    1. Ilyas F Chemically-laced mehndi in widespread use from. Dawn News; September 29, 2008. Available from: . Accessed December4, 2020.
    1. Romieu II, Amadou A, Chajes V. The role of diet, physical activity, body fatness, and breastfeeding in breast cancer in young women: epidemiological evidence. Rev Invest Clín. 2017;69(4):193–203.
    1. Liede A, Malik IA, Aziz Z, De Los Rios P, Kwan E, Narod SA. Contribution of BRCA1 and BRCA2 mutations to breast and ovarian cancer in Pakistan. Am J Hum Genet. 2002;71(3):595–606. doi:10.1086/342506
    1. Caplan LS, Helzlsouer KJ. Delay in breast cancer: a review of the literature. Public Health Rev. 1992;20(3–4):187–214.
    1. Scheel JR, Anderson S, Foerster M, Galukande M, McCormack V. Factors contributing to late-stage breast cancer presentation in sub-Saharan Africa. Curr Breast Cancer Rep. 2018;10(3):142–147. doi:10.1007/s12609-018-0278-7
    1. Shamsi U, Khan S, Azam I, et al. Patient delay in breast cancer diagnosis in two hospitals in Karachi, Pakistan: preventive and life-saving measures needed. JCO Glob Oncol. 2020;6:873–883. doi:10.1200/GO.20.00034
    1. Sarwar MR, Saqib A. Cancer prevalence, incidence and mortality rates in Pakistan in 2012. Cogent Med. 2017;4(1):1288773. doi:10.1080/2331205X.2017.1288773
    1. Banning M, Hafeez H, Faisal S, Hassan M, Zafar A. The impact of culture and sociological and psychological issues on Muslim patients with breast cancer in Pakistan. Cancer Nurs. 2009;32(4):317–324. doi:10.1097/NCC.0b013e31819b240f
    1. Soomro R, Faridi S, Khurshaidi N, Zahid N, Mamshad I. Age and stage of breast cancer in Pakistan: an experience at a tertiary care center. J Pak Med Assoc. 2018;68(11):1682–1685.
    1. Gulzar F, Akhtar MS, Sadiq R, Bashir S, Jamil S, Baig SM. Identifying the reasons for delayed presentation of Pakistani breast cancer patients at a tertiary care hospital. Cancer Manag Res. 2019;11:1087. doi:10.2147/CMAR.S180388
    1. Khan MA, Hanif S, Iqbal S, Shahzad MF, Shafique S, Khan MT. Presentation delay in breast cancer patients and its association with sociodemographic factors in North Pakistan. Chin J Cancer Res. 2015;27(3):288.
    1. Pace LE, Mpunga T, Hategekimana V, et al. Delays in breast cancer presentation and diagnosis at two rural cancer referral centers in Rwanda. Oncologist. 2015;20(7):780. doi:10.1634/theoncologist.2014-0493
    1. Salih AM, Alfaki MM, Alam-Elhuda DM, Nouradyem MM. Factors delaying presentation of Sudanese breast cancer patients: an analysis using Andersen’s Model. Asian Pac J Cancer Prev. 2016;17(4):2105–2110. doi:10.7314/APJCP.2016.17.4.2105
    1. Ginsburg O. Breast and cervical cancer control in low and middle-income countries: human rights meet sound health policy. J Cancer Policy. 2013;1(3–4):e35–e41. doi:10.1016/j.jcpo.2013.07.002
    1. Globocan. Globocan Pakistan Fact Sheet; 2019. Available from: . Accessed March7.
    1. Ashraf MS, Jamil A. Cancer Care in Pakistan. Cancer Care in Countries and Societies in Transition. Springer; 2016:231–245.
    1. Banning M, Tanzeem T. Managing the illness experience of women with advanced breast cancer: hopes and fears of cancer-related insecurity. Eur J Cancer Care (Engl). 2013;22(2):253–260. doi:10.1111/ecc.12026
    1. Hanif M, Sabeen B, Maqbool A, Ahmed A, Nadeem F, Habib S. Breast cancer: incidence (Thirteen year data analysis) and one year clinicopathological data of patients in a tertiary care cancer hospital. Int J Biol Biotechnol. 2015;12(3):373–379.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe