title: A review of breast cancer awareness among women in India: Cancer literate or awareness deficit?
abstract: BACKGROUND
  Breast cancer is the most common female cancer worldwide including India, where advanced stages at diagnosis, and rising incidence and mortality rates, make it essential to understand cancer literacy in women. We conducted a literature review to evaluate the awareness levels of risk factors for breast cancer among Indian women and health professionals.
  
  
  METHODS
  A structured literature search using combined keywords was undertaken on bibliographic databases including MEDLINE, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health (CINAHL) and SCOPUS. Searches were restricted to research published in English language peer-reviewed journals through December, 2014 in India.
  
  
  RESULTS
  A total of 7066 women aged 15-70 years showed varied levels of awareness on risk factors such as family history (13-58%), reproductive history (1-88%) and obesity (11-51%). Literacy levels on risk factors did not improve over the 8-year period (2005-2013). On average, nurses reported higher, though still varied, awareness levels for risk factors such as family history (40.8-98%), reproductive history (21-90%) and obesity (34-6%). Awareness levels were not consistently higher for the stronger determinants of risk.
  
  
  CONCLUSIONS
  Our review revealed low cancer literacy of breast cancer risk factors among Indian women, irrespective of their socio-economic and educational background. There is an urgent need for nation- and state-wide awareness programmes, engaging multiple stakeholders of society and the health system, to help improve cancer literacy in India.
authors.affiliation: South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India.
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.affiliation: South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India; Centre for Chronic Conditions & Injuries, Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India.
authors.forename: K
authors.initials: K
authors.lastname: Shridhar
authors.affiliation: South Asia Network for Chronic Disease (SANCD), Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India; Centre for Chronic Conditions & Injuries, Public Health Foundation of India, 4th Floor, Plot No. 47, Sector 44, Gurgaon 122002, India. Electronic address: preet.dhillon@phfi.org.
authors.forename: P K
authors.initials: PK
authors.lastname: Dhillon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001364:Awareness; D001943:Breast Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D007194:India / Q000453:epidemiology; D008875:Middle Aged; D065840:Protective Factors; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Awareness; Breast cancer; India; Risk factors; Women