Breast Cancer Incidence Increasing in Younger Women in Urban Areas
Author(s): City Air NewsNew Delhi, December 3, 2015: Increasing urbanization, adoption of westernized lifestyles, and shift in reproductive behavior are factors contributing to the rising incidence of breast cancer in India, with increasing...
cityairnews
Dec 3, 2015 10:30
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New Delhi, December 3, 2015: Increasing urbanization, adoption of westernized lifestyles, and shift in reproductive behavior are factors contributing to the rising incidence of breast cancer in India, with increasing number of younger women reporting the disease.
Dr Ashish Singh, Associate Professor, Medical Oncologist, CMC, Vellore says it is highly important to educate Indian women about the rising incidence of the disease, its risk factors and the fact that younger women too today are presenting with the disease.
In 2013, American researchers analyzed cancer registry data between 1976 and 2009 and concluded that there was a steady rise in number of younger women reporting more aggressive forms of cancer.
“While there is no such comprehensive study conducted in India, clinical evidence and recent reports from the ICMR registries suggests that breast cancer occurrence has increased in relatively younger women today. Many patients are not diagnosed at early stages and that is the reason why mortality from the disease is higher in India as compared to the developed world. Breast cancer is today the leading cause of cancer related deaths in women in India, surpassing cervical cancer,” says Dr Ashish Singh.
According to estimates of World Health Organization, roughly 144,937 women in India were detected with breast cancer in 2012 and 70,218 died of it. With the incidence of the disease rising by more than 20% since 2008, India is expected to have a whopping 200,000 new cases of breast cancer per year by 2030. 1 in 25 women in India will develop breast cancer during their life-time.
“The incidence is relatively higher in urban women as compared to rural population. Age of presentation is also relatively younger as compared to western population. Almost one-third of patients in India present in advanced stage of the disease when it becomes difficult to cure it or prolong the patient’s life. In contrast, just about 5% of patients in developed countries present at the advanced stage,” says Dr Ashish Singh.
“Possible causes for this downward shift in age of patients include lifestyle factors such as rise in obesity, change in dietary habits, lack of physical activity, late pregnancies, reduced breastfeeding, and increased consumption of processed food. These factors together may be gradually increasing their contribution to cancer risk,” adds Dr Singh.
The three major risk factors for breast cancer that cannot be modified or reduced by action are age, sex and genetic predisposition to the disease. However, there has been a substantial rise in recent years in another set of risk factors that can be modified by taking timely action – lifestyle. In fact, some experts estimate that lifestyle modification can prevent up to 30% of all types cancers.
Modifiable Risk Factors
Modifiable risk factors include reproductive factors like late pregnancy, reduced duration of breast feeding, obesity, physical inactivity, smoking and unhealthy eating habits. A study conducted in the U.S. showed a higher incidence in women doing more night shifts at work which may be indirectly related to increased stress, lack of exercise and other interrelated factors. Encouraging long term breast feeding practices, preventing delay in first pregnancy, keeping the Body Mass Index in control, and regular exercise can go a long way in reducing risk of acquiring breast cancer.
Self Examination
In a country like India where breast cancer screening is yet to become a norm, regular self examination is a very important aspect. Monthly self examination, preferably at the end of the period can help a woman identify what her normal breast feels like and this may help her in detecting any anomaly like a lump or difference in shape early on.
Screening
“Almost half of the breast cancer deaths in India can be preventable if the disease is presented in stage I or II. Unfortunately, up to 60% of breast cancers in India are diagnosed by the time they reach stage III or IV, making prognosis poor, and causing high mortality. Early diagnosis not only saves lives by detecting the disease when it is curable, but also allows doctors to undertake less intensive and less morbid treatments which ensure shorter and cheaper treatment,” says Dr Singh.
Who should be screened for breast cancer?
Experts recommend screening for most women age 50 to 70, and for some older women who are healthy. (Screening should involve mammograms, as well as breast exams done by a doctor or nurse.) Some women age 40 to 49 should also be screened. For instance, women who are at high risk of breast cancer sometimes need to begin screening at a young age. This might include women who:
?Carry genes that increase their risk of breast cancer, such as the “BRCA” genes
?Have close relatives who got breast cancer at a young age
What if my mammogram is abnormal?
If your mammogram is abnormal, don't panic. Nine out of 10 women with an abnormal mammogram turn out NOT to have breast cancer. You will need more tests to find out what's really going on.
Understanding the tradeoff between benefit and harm
Overdiagnosis, which occurs relatively rarely, is a serious harm because it means that some women diagnosed with breast cancer are treated for lesions that would not have caused them harm if the cancers had never been identified. The benefits and harms of screening for breast cancer should be discussed with all women. Discussing risks and benefits of mammography for women aged 40 to 50 is especially important because the absolute benefits of screening are smaller and the associated risks associated are greater than in older women.
Date:
Thursday, December 3, 2015
