Byline: Lavandan. Jegatheeswaran, Payal. Haria, Byung. Choi, Thin. Phyu Naing, Ed. Babu, Arunmoy. Chakravorty
Breast cancer is now one of the most prevalent cancers in Indian cities and certain rural areas. India lacks a dedicated breast cancer screening program. This review explores the barriers to the successful implementation of breast cancer screening in India and aims to offer plausible pathways in potentially making this initiative a reality.
As of July 2019, India's population stands at 1,366,418,000, thus making it the second-most populous country in the world. Under the tax-financed public system, all citizens of India are entitled to free health-care services; however, due to the large bottlenecks in the access of public health care, it is estimated that almost 70% of Indian citizens deviate toward private care., The World Bank estimated the total health expenditures in India from March 2015 to March 2016 as 3.66% of Gross Domestic Product (GDP). The Indian government expenditure on health care at the same time amounted to 0.93% of GDP. Given that the target threshold for the percentage GDP as total health-care expenditure lies at 5% for all United Nations member states, as a part of the sustainable development goals to achieve universal health-care coverage by 2030, it is apparent that India's commitment needs to improve., In order to achieve universal health coverage, there are key areas that the Indian government should consider focusing their health-care expenditure on, including implementing national screening programs for prevalent diseases and conditions and improving access to health care.
One such prevalent condition is breast cancer, which has overtaken the incidence rates of cervical cancer and is now the most prevalent cancer in most Indian cities and some rural areas. Studies have shown that women in India are less likely to develop breast cancer than women in western countries. This is likely due to the nature of Indian society, where risk factors for breast cancer, i.e., increased estrogen exposure such as late or absent full-term pregnancy and short or absent length of breastfeeding are less frequent than in Western societies. Despite this, breast cancer figures are still estimated to be between 19% and 34% of all cancer cases in women in India. It is also interesting to note that breast cancer tends to affect Indian women, on average, almost a decade earlier when compared to their western counterparts., The implementation of breast cancer screening programs has been proven to be hugely effective in western countries, with breast cancer-related mortality in the UK estimated to have decreased by 20% since the birth of its national screening program in 1988. However, no such equivalent screening mechanism exists in India, and the purpose of this review is to identify a plausible way of introducing such an initiative to this country.
There are a multitude of factors affecting the successful implementation of a nationwide breast cancer screening program in India. Firstly, the lack of breast cancer awareness and education. Breast cancer awareness programs, if present, tend to be concentrated in urban areas, with...
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