Cancer early detection program based on awareness and clinical breast examination: Interim results from an urban community in Mumbai, India

Breast. 2017 Feb;31:85-89. doi: 10.1016/j.breast.2016.10.025. Epub 2016 Nov 6.

Abstract

Indian women with breast cancer are usually diagnosed in advanced stages leading to poor survival. Improving breast awareness and increasing access to early diagnosis and adequate treatment has been advocated for breast cancer control. We implemented a program to increase awareness on breast cancer and access to its early detection in an occupational health care scheme in Mumbai, India. Breast awareness brochures were mailed annually between June 2013 and June 2016 to a cohort of 22,500 eligible women aged 30-69 years old receiving universal health care from an occupational health care scheme comprising of primary health centres and a referral secondary care hospital in Mumbai. Women with suspected breast cancers were provided with diagnostic investigations and treatment. Socio-demographic information and tumour characteristics were compared between the breast awareness pre-intervention period (Jan 2005-May 2013) and the breast awareness intervention period after four rounds of mailers (June 2013-June 2016). The proportion of women with early tumours and axillary lymph node negative cancers increased from 74% to 81% and 46% to 53% respectively, between the two periods. While the proportion of patients receiving breast conserving surgery increased from 39% to 51%, the proportion receiving chemotherapy decreased from 84% to 56%. Interim results following efforts to improve breast awareness and access to care in a cohort of women in an occupational health care scheme indicate early detection and more conservative treatment of breast cancers. Creating awareness and improving access to care may result in cancer down-staging.

Keywords: Breast awareness; Breast cancer; Cancer control; Early detection; Low- and medium-income countries.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / psychology
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / methods
  • Health Promotion / statistics & numerical data*
  • Humans
  • India / epidemiology
  • Mass Screening / methods
  • Mass Screening / psychology
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Occupational Health
  • Physical Examination / methods
  • Physical Examination / psychology
  • Physical Examination / statistics & numerical data
  • Program Evaluation*
  • Urban Population / statistics & numerical data*