Breast cancer screening rate among middle-aged women in India low: Study

New Delhi: The mammography rate in India is low as only 1 percent of women aged 45 years and above undergo breast cancer screening, with the highest uptake in Kerala and lowest in Nagaland, according to a study.

Researchers, including those from Tata Memorial Centres in Mumbai and Varanasi, said that mammography rates in India are much lower than those from around the world — 4.5 percent in African countries, 40-60 percent in Asian countries such as Korea and Japan, and 84 percent in European and American populations.

Within India, the analysis showed inter-state disparities. The highest prevalence of mammography was reported from Kerala and Karnataka — 4.5 percent and 2.9 percent, respectively, while Nagaland reported the lowest at zero per cent, with Andhra Pradesh and Uttarakhand also reeling at the bottom with 0.1 percent and 0.27 percent, respectively.

The findings of the study, published in the journal BioMed Central (BMC) Public Health, highlight an “inadequate coverage” of early detection of breast cancer under the NPCDCS programme.

The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) was launched in 2010, focussing on strengthening healthcare infrastructure and early diagnosis.

While the NPCDCS also recommends a clinical breast examination for women aged 30-65 years at 5-year intervals, the researchers said there is a paucity of representative data regarding the use of early breast cancer detection.

For the study, the team analysed data of over 35,000 women from the ‘Longitudinal Aging Study of India’ — a nationally representative study of over 73,000 adults aged 45 years and above. Wave 1 survey was conducted in 2017-18.

Results of the analysis revealed that the prevalence of mammography was 1.3 per cent among Indian women aged 45 years and above, 1.7 per cent among 45-59 years and 0.9 per cent among women aged 60 years and above.

Further, among women aged 45-59 years, factors such as education and health conditions (diabetes, neurological illness and reproductive health problems) were associated with a higher uptake of mammography.

A previous study of data from the fifth round of the National Family Health Survey, published in the International Journal of Cancer in 2022, reported that only one per cent of women aged 30-49 years underwent a clinical screening for breast cancer.

However, the rates are much lower than the 70 per cent coverage, as recommended in the NPCDCS guidelines, the researchers said.

Women in India bear a disproportionate burden due to cancer, as breast cancer continues to be the most prevalent type, contributing to 13.8 per cent of new cancer cases, according to a recent Indian Council of Medical Research-study, published in The Lancet Regional Health Southeast Asia journal.

As the country’s population ages, India could be expected to face a formidable challenge in managing deaths related to cancer incidence in the coming two decades, with a projected yearly increase of two per cent in cases as the population ages, it said.