Cancer early detection program based on awareness and clinical breast examination: Interim results from an urban community in Mumbai, India.
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.
Department of Surgery, Bhabha Atomic Research Centre Hospital, Mumbai, India.
Anita
A
Gadgil
Screening Group, Early Detection and Prevention Section, International Agency for Research in Cancer, Lyon, France. Electronic address: SauvagetC@iarc.fr.
Catherine
C
Sauvaget
Department of Surgery, Bhabha Atomic Research Centre Hospital, Mumbai, India.
Nobhojit
N
Roy
Screening Group, Early Detection and Prevention Section, International Agency for Research in Cancer, Lyon, France.
Richard
R
Muwonge
Department of Radiology, Bhabha Atomic Research Centre Hospital, Mumbai, India.
Surita
S
Kantharia
Community Dispensaries, Bhabha Atomic Research Centre, Mumbai, India.
Anuradha
A
Chakrabarty
Community Dispensaries, Bhabha Atomic Research Centre, Mumbai, India.
Kanchan
K
Bantwal
Community Dispensaries, Bhabha Atomic Research Centre, Mumbai, India.
Indrani
I
Haldar
Screening Group, Early Detection and Prevention Section, International Agency for Research in Cancer, Lyon, France.
Rengaswamy
R
Sankaranarayanan
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D008403:Mass Screening / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D016272:Occupational Health; D010808:Physical Examination / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D015397:Program Evaluation; D014505:Urban Population / Q000706:statistics & numerical data*
Breast awareness; Breast cancer; Cancer control; Early detection; Low- and medium-income countries