Public Health Awareness of Breast Cancer in Rural India: A Comprehensive Review

Debashmita Banerjee; Srishti  Tripathi; Fatima RL Kh; Benrithung  Murry

doi:10.55489/njcm.160520255048

Authors

Debashmita Banerjee Department of Anthropology, University of Delhi, New Delhi, India
Srishti Tripathi Department of Anthropology, University of Delhi, New Delhi, India https://orcid.org/0009-0005-4153-8362
Fatima RL Kh Department of Anthropology, University of Delhi, New Delhi, India
Benrithung Murry Department of Anthropology, University of Delhi, New Delhi, India https://orcid.org/0000-0002-8789-2229

DOI:

https://doi.org/10.55489/njcm.160520255048

Keywords:

Awareness, Breast Cancer, Public health, Rural Population, India

Abstract

Objective: This comprehensive review endeavours to evaluate the degree of breast cancer awareness among rural Indian women.

Methods: The PRISMA guideline was followed in this systematic review. Qualitative and quantitative literature from 2000-2023 was searched in PubMed, Science Direct, Medline and Google Scholar. Individuals in India were targeted, with a cross-sectional or prevalence-based approach in healthcare settings. Studies stating health awareness values were gathered from adult breast cancer patients or those without cancer were included. Papers were limited to English, 2012-2022. Duplicate, meta-analyses, non-human, inadequate data and non-English publications were excluded. Grey literature was searched, but access limitations were faced.

Result: Widespread lack of awareness about breast cancer, coupled with limited access to screening, contributes to late diagnoses and increased mortality. Cultural stigma surrounding breast health impedes early detection and intervention. Inadequate healthcare, especially in rural areas, poses challenges to effective cancer care. Financial constraints hinder access to necessary medical services.

Conclusion: A holistic approach involving awareness campaigns, improved infrastructure, increased screening accessibility, and efforts to destigmatize breast health is required. Collaborative endeavors by stakeholders are crucial to mitigate breast cancer's impact on the Indian population and improve healthcare awareness, especially in rural areas.

References

Cao W, Chen HD, Yu YW, Li N, Chen WQ. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chinese Medical Journal. 2021 Apr 5;134 (7):783-91. DOI: https://doi.org/10.1097/CM9.0000000000001474 PMid:33734139 PMCid:PMC8104205

Mehrotra R, Yadav K. Breast cancer in India: Present scenario and the challenges ahead. World Journal of Clinical Oncology. 2022 Mar 24;13(3):209-18. DOI: https://doi.org/10.5306/wjco.v13.i3.209 PMid:35433294 PMCid:PMC8966510

Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, et al. Breast Cancer Statistics, 2022. CA A Cancer J Clinicians. 2022 Nov;72(6):524-41. DOI: https://doi.org/10.3322/caac.21754 PMid:36190501

Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer: Target and therapy. 2019 Apr; Volume 11:151-64. DOI: https://doi.org/10.2147/BCTT.S176070 PMid:31040712 PMCid:PMC6462164

Brewer HR, Jones ME, Schoemaker MJ, Ashworth A, Swerdlow AJ. Family history and risk of breast cancer: an analysis accounting for family structure. Breast Cancer Res Treat. 2017 Aug;165(1):193-200. DOI: https://doi.org/10.1007/s10549-017-4325-2 PMid:28578505 PMCid:PMC5511313

Stordal B. Breastfeeding reduces the risk of breast cancer: A call for action in high‐income countries with low rates of breastfeeding. Cancer Medicine. 2023 Feb;12(4):4616-25. DOI: https://doi.org/10.1002/cam4.5288 PMid:36164270 PMCid:PMC9972148

Li Y, Zheng J, Deng Y, Deng X, Lou W, Wei B, et al. Global Burden of Female Breast Cancer: Age-Period-Cohort Analysis of Incidence Trends from 1990 to 2019 and Forecasts for 2035. Frontiers in Oncology. 2022 Jun 9; 12:891824. DOI: https://doi.org/10.3389/fonc.2022.891824 PMid:35756641 PMCid:PMC9218744

Francies FZ, Hull R, Khanyile R, Dlamini Z. Breast cancer in low-middle income countries: Abnormality in splicing and lack of targeted treatment options. American Journal of Cancer Research 2020;10(5): 1568-1591.

Braveman P, Gottlieb L. The Social Determinants of Health: It's Time to Consider the Causes of the Causes. Public Health Rep. 2014 Jan;129(1_suppl2):19-31. DOI: https://doi.org/10.1177/00333549141291S206 PMid:24385661 PMCid:PMC3863696

Gupta A, Shridhar K, Dhillon PK. A review of breast cancer awareness among women in India: Cancer literate or awareness deficit? European Journal of Cancer. 2015 Sep;51(14):2058-66. DOI: https://doi.org/10.1016/j.ejca.2015.07.008 PMid:26232859 PMCid:PMC4571924

Prusty RK, Begum S, Patil A, Naik DD, Pimple S, Mishra G. Knowledge of symptoms and risk factors of breast cancer among women: a community based study in a low socio-economic area of Mumbai, India. BMC Women's Health. 2020 Dec;20(1):106. DOI: https://doi.org/10.1186/s12905-020-00967-x PMid:32423488 PMCid:PMC7236367

Sen S, Khan PK, Wadasadawala T, Mohanty SK. Socio-economic and regional variation in breast and cervical cancer screening among Indian women of reproductive age: a study from National Family Health Survey, 2019-21. BMC Cancer. 2022 Dec 7;22(1):1279. DOI: https://doi.org/10.1186/s12885-022-10387-9 PMid:36476339 PMCid:PMC9727878

Daniel S, Venkateswaran C, Singh C, Hutchinson A, Johnson MJ. "So, when a woman becomes ill, the total structure of the family is affected, they can't do anything…" Voices from the community on women with breast cancer in India: a qualitative focus group study. Support Care Cancer. 2022 Jan;30(1):951-63. DOI: https://doi.org/10.1007/s00520-021-06475-4 PMid:34420101 PMCid:PMC8636417

Fitzmaurice C, Dicker D, Pain A, Hamavid H, Moradi-Lakeh M, MacIntyre MF, et al. The Global Burden of Cancer 2013. JAMA Oncol. 2015 Jul 1;1(4):505.

Chalkidou K, Marquez P, Dhillon PK, Teerawattananon Y, Anothaisintawee T, Gadelha CAG, et al. Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries. The Lancet Oncology. 2014 Mar;15(3):e119-31. DOI: https://doi.org/10.1016/S1470-2045(13)70547-3 PMid:24534293

Tripathi N, Kadam YR, Dhobale RV, Gore AD. Barriers for early detection of cancer amongst Indian rural women. South Asian J Cancer. 2014 Apr;3(2):122-7. DOI: https://doi.org/10.4103/2278-330X.130449 PMid:24818108 PMCid:PMC4014643

Parchuri SS, Palanki SD, Nirni SS, Atilli SS, Andra VV, Ch VM. Impact of education for breast self examination in rural Indian women on early detection: Results of POC study. Annals of Oncology. 2019 Oct;30:v76-7. DOI: https://doi.org/10.1093/annonc/mdz240.054

Kathrikolly T, Shetty R, Nair S. Opportunities and Barriers to Breast Cancer Screening in a Rural Community in Coastal Karnataka, India: A Qualitative Analysis. Asian Pac J Cancer Prev. 2020 Sep 1;21(9):2569-75. DOI: https://doi.org/10.31557/APJCP.2020.21.9.2569 PMid:32986354 PMCid:PMC7779458

Khapre M, Ravi B, Sharda P, Mehta A, Kumari R. Evaluation of an Interventional Health Education Project: Screening of Breast Cancer and Health Education (SHE). Asian Pac J Cancer Prev. 2022 Jul 1;23(7):2361-6. DOI: https://doi.org/10.31557/APJCP.2022.23.7.2361 PMid:35901342 PMCid:PMC9727362

Baburajan C, Pushparani MS, Lawenya M, Lukose L, Johnson AR. Are rural women aware of breast cancer and do they practice breast self-examination? A cross-sectional study in a rural hospital in South India. Indian Journal of Cancer. 2022 Jul;59(3):354-9. DOI: https://doi.org/10.4103/ijc.IJC_799_19 PMid:33753612

Ray K, Chhakchhuak V, Basu M, Shukla V. Knowledge, attitude and practice regarding breast and cervical cancer among women of reproductive age residing in a rural area of West Bengal, India. IMC Journal of Medical Science. 2023;17(2):011. DOI: https://doi.org/10.55010/imcjms.17.021

Singh S, Pal A, Srivastava NK, Thakur P. Level of Awareness and Practices of Women Regarding Breast Cancer in Chhattisgarh, India: An Institution Based Survey. IJMEDPH. 2018 Dec 10;8(4):145-51. DOI: https://doi.org/10.5530/ijmedph.2018.4.30

Malik R, Vera N, Dayal C, Choudhari A, Mudaliar J, Noovao Hill A, et al. Factors associated with breast cancer awareness and breast self-examination in Fiji and Kashmir India - a cross-sectional study. BMC Cancer. 2020 Dec;20(1):1078. DOI: https://doi.org/10.1186/s12885-020-07583-w PMid:33167928 PMCid:PMC7654031

Kumarasamy H, Veerakumar A, Subhathra S, Suga Y, Murugaraj R. Determinants of awareness and practice of breast self-examination among rural women in Trichy, Tamil Nadu. J Mid-life Health. 2017;8(2):84. DOI: https://doi.org/10.4103/jmh.JMH_79_16 PMid:28706409 PMCid:PMC5496285

Gogia A, Deo SVS, Sharma D, Thulkar S, Kumar R, Malik PS, et al. Clinicopathologic Characteristics and Treatment Outcomes of Patients with Up-Front Metastatic Breast Cancer: Single-Center Experience in India. JGO. 2019 Dec;(5):1-9. DOI: https://doi.org/10.1200/JGO.18.00265 PMCid:PMC6449077

Sharma V, Giri S. Cancer control in India- A sorry state. Indian J Cancer. 2009;46(4):340. DOI: https://doi.org/10.4103/0019-509X.55557

Nagrani R, Budukh A, Koyande S, Panse N, Mhatre S, Badwe R. Rural urban differences in breast cancer in India. Indian J Cancer. 2014;51(3):277-281. DOI: https://doi.org/10.4103/0019-509X.146793 PMid:25494122

Mehrotra R, Yadav K. Breast cancer in India: Present scenario and the challenges ahead. WJCO. 2022 Mar 24;13(3):209-18. DOI: https://doi.org/10.5306/wjco.v13.i3.209 PMid:35433294 PMCid:PMC8966510

Sirohi B. Cancer care delivery in India at the grassroot level: Improve outcomes. Indian Journal of Medical and Paediatric Oncology. 2014 Jul;35(03):187-91. DOI: https://doi.org/10.4103/0971-5851.142030 PMid:25336787 PMCid:PMC4202612

Dikshit R, Gupta PC, Ramasundarahettige C, Gajalakshmi V, Aleksandrowicz L, Badwe R, et al. Cancer mortality in India: a nationally representative survey. The Lancet. 2012 May;379(9828):1807-16. DOI: https://doi.org/10.1016/S0140-6736(12)60358-4 PMid:22460346