BackUrbanization associated with increasing breast cancer in India: WHO
The World Cancer Report 2020, which was released on Tuesday, noted that in India the incidence of breast cancer is consistently increasingThe report has highlighted that most effective intervention for breast cancer control is early detection and prompt treatment
PremiumUrbanization appears to be associated with an increasing incidence of breast cancer in India, the World Health Organisation (WHO) has said in a report.
The World Cancer Report 2020, which was released on Tuesday, noted that in India the incidence of breast cancer is consistently increasing, as shown by data from several population-based cancer registries. The most developed states according to the report witnessed the highest breast cancer rates in the country.
“The diverging incidence trends for breast cancer and cervical cancer in India may be partly explained by improvements in the socioeconomic status of women, as indicated by higher education levels, increasing household incomes, later ages at marriage and at first birth, lower parity, and increasing adoption of sedentary lifestyles, dietary patterns typical of industrialized countries, and lower levels of physical activity in successive generations of women," the report said.
“In India, high socioeconomic status is associated with a higher prevalence of overweight and obesity and with a shift towards sedentary lifestyles and dietary patterns typical of industrialized countries, which are established risk factors for breast cancer; households with high socioeconomic status spend less on cereals, millets, and vegetables and more on beverages, processed foods, dairy products, meat, eggs, and fish," it said.
Cancer experts agree with the apex agency’s findings. “Increasing urbanization, unfortunately, often results in unhealthy lifestyle translating to sedentary habits, increasing use of alcohol and obesity. Often women having late marriages, fewer children, either not breast feeding or feeding for lesser duration, early menarche and late menopause - thus increasing exposure to hormones," said Ravi Mehrotra, Chief Executive Officer (CEO), Indian Cancer Research Consortium- Indian Council of Medical Research (ICMR).
The report has highlighted that most effective intervention for breast cancer control is early detection and prompt treatment. “Breast awareness and participation in screening are conducive to early detection and completion of treatment," the report said.
“We are increasingly seeing younger females who are developing breast cancer for various reasons such as obesity. Lack of physical activity and sedentary lifestyle, consumption of junk food, fatty meals, ready to make food, leads to obesity that leads to excess production of a hormone called aromatase. Aromatase converts male hormone to female hormone estrogen. Higher exposure to female hormone estrogen directly increases risks of breast cancer," said P K Julka, senior director, medical oncology, Max Healthcare.
“Women should be encouraged and taught self breast examination, post 20 years of age and clinical examination post 30 years of age- to identify any lump in their breasts - painful or painless, and immediately meet a clinician to rule out cancer," he said.
The report has showed that the breast cancer awareness was more prevalent in bigger cities and the women with high socioeconomical backgrounds don’t avail medical services in public hospitals.
The WHO report cited that the in a cross-sectional study of breast cancer screening practices in Kerala, women with higher socioeconomic status were found to be more likely to participate in screening compared with other women. Also, in a recent study in Mumbai, women with higher socioeconomic status were found to have higher breast awareness than women with lower socioeconomic status. Two large randomized trials of screening by clinical breast examination in India have shown that clinical breast examination screening is followed by early diagnosis of breast cancer, the report highlighted.
It also cited that findings from a randomized trial in Kerala indicated that women who had a higher education level and a higher household income, were employed in non-manual occupations, and were living in better housing were more likely to have breast awareness and to practice breast self-examination but less likely to participate in clinical breast examination screening, which was offered in the trial by the public health services, the report said.
“A possible explanation for these paradoxical findings is that women with higher socioeconomic status have less faith in public health services, can afford private health care, and seek mammography screening elsewhere. Similar findings were reported in a breast cancer screening trial in Mumbai," the report said.
“With advancements in treatment and technology, every patient is treated individually based on his/her clinical profile and genetic profile, so this is called comprehensive genomic profiling which has bought precision medicine and personalized medicine at the forefront of breast cancer treatment," said Jhulka.
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