Pakistan has highest incident of Breast Cancer in Asia - Dr. Adil Ramzan

Breast cancer is the commonest cancer of women all over the world. But in Asia, Pakistan is the country that has the highest incident of breast cancer according to 2014 statistics. According to a study that is done by the doctors of Agha Khan Hospital Karachi, every one out of 9 women has breast cancer in Pakistan. This is the highest in Asia.
In Capital Hospital Islamabad, during a weekly academic conference, Dr Naeem Taj, the head of the surgical department, told the audience that breast cancer has high mortality and morbidity in Pakistan because in here, it is diagnosed in late stages. Most of the patients we receive in our general OPD usually have Grade III or Grade IV disease.

The main reason for the late presentation is poverty, lack of facilities, illiteracy, lack of information, lack of interest of the government in the health sector and women’s shyness.

For example, if a woman has a lump and present to a secondary level hospital that doesn’t have the facility of breast clinic, mammography, biopsy, and histopathology, she is referred for tertiary care but due to unaffordability or any other reason, she doesn’t go there. Moreover, first, those women who belong to the peripheral and rural areas go to local Quacks and religious scholars for remedy and all this delay the diagnosis and specific treatment. If breast cancer is caught early, then there is a 100% cure. The 5-year survival after grade 1 breast cancer is 100% and after grade 2 breast cancer is 93% but it greatly decreases if breast cancer enters grade 3 or grade 4 at the time of diagnosis. So it the early diagnosis that is important.

In Pakistan, surgeons and doctors send the biopsy specimen to distant centres for histopathological examination. For example, Capital hospital that is situated in Islamabad send the biopsy specimen to Military Hospital Rawalpindi for histopathological examination and sometimes doctors have to wait for a month to get the report and in the meantime, the patient of breast cancer enters stage 3. Thus her disease spreads and it is the time that should be saved in case of a patient who has breast cancer and she should get treatment without delay.

In western countries, after 40 years of age, every woman automatically enters into the breast cancer screening program. Where every woman is scientifically examined for signs of breast cancer every year and most of the women are caught at stage 0 (carcinoma in situ), they are immediately referred for mastectomy and reconstruction, and are saved from breast cancer. But in countries like Pakistan, even those women who have large lumps in their breasts fail to get treatment for months.

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Reference:

Knowledge attitude and practices among urban women of Karachi, Pakistan, regarding breast cancer
url: https://www.jpma.org.pk/full_article_text.php?article_id=3820