Late diagnosis of breast cancer in India linked to cultural issues, says study

A new study, which is the first of its kind to analyse breast cancer awareness in India, published in the Journal of Business Research, suggests that due to the lack of early diagnosis, the country is moving towards an epidemic.

This research links the lack of early diagnosis of the disease to traditional and cultural issues and denotes that the women in the country do not seek health services and are unwilling to consult male doctors. Over-dependency on the family members in accessing medical care, neglecting ones’ own health because of family commitments, etc. contribute to the delay in diagnosing the disease.

According to the study, in creating awareness for the disease, traditional marketing campaigns do not work; the most effective medium is community nurses. Also, a better understanding by men can help in the early diagnosis.

The consequence of rapid economic development of the nation that leads to greater urbanization is underlined in the study. This development paves a way for some women to shift to a western lifestyle, increasing the rates of breast cancer. The study labels the issue as one of the major health concerns faced by the country presently.

In order to explore the unique cultural, economic, social as well as institutional challenges of this evolving economy, Judith Fletcher-Brown, from the University of Portsmouth, visited the nation and her findings indicate that, among women in cities and urban area of India, the most commonly diagnosed cancer is the breast cancer.

Due to breast cancer, 70,218 women in the nation died in the year 2012. It is forecasted that the number might rise to 76,000 in the year 2020, with a shift in the mean age of incidence from 50 years to 30 years. Yet, due to the lack of knowledge on self-examination as well as cultural obstacles, women pursue medical help extremely late.

To acquire the most open answers to the questions on personal experiences, Judith interviewed several women through e-mail. One of the participants reported that even though there is more openness among daughters and mothers, and even between friends they are too shy.

According to Judith, in India which is still a patriarchal society, men acts as the head of the household, while women are presently in responsible jobs and earns for families. Educated and professional women too are not seen as discussing their private matters on their physique to their fathers, brothers or even husbands. Therefore, to raise awareness in men as well as make them willing to discuss such problems, it is necessary to direct the messages on health towards them. To enable female members of the family to get medical care at the earliest, men’s understanding on the issue is vital.

Focus groups which consisted experts among several breast cancer medical practitioners were also included by her. They are of an opinion that, in India, the subject is a taboo and people rarely discuss this among men and women or even husbands and wives in families.

Judith found that in creating awareness among men and women on early symptoms of the cancer, community health nurses had the highest influence. In overcoming cultural barriers, these Accredited Social Health Activists (ASHAs) entrenched in the community are more effective than national advertising campaigns as they have the trust of the women at risk as well as their husbands and fathers.

According to the study, the second best channel to raise awareness in young women are schools and media – which succeeded in raising awareness through charity initiatives - has the third place. Traditional marketing campaign was one among the least impacted channels.

Women are having fewer children later in life and breast feeding them less which increases their chance of developing the disease. Working women in urban India often have a more western diet leading to obesity which also increases the risk alongside a lack of infrastructure for early diagnosis.”

Judith Fletcher-Brown, from the University of Portsmouth

She added that the developing economy of the country has given the women novel economic independence as well as opportunities in career; yet, these educational women are put to risk due to the lack of awareness in breast cancer.

The Government of India, after recognising these issues, has invested money in marketing campaigns through non-governmental organizations (NGOs). However, the findings of the study show that these campaigns are not successful in reaching the target audience.

The manifestations of this crisis in India are mostly evident in the flourishing cities like Delhi, Mumbai, Bhopal, Kolkata, Bengaluru, Chennai and Ahmedabad, where job opportunities for women are rising.

A new report states that providing employment to more women in the country might add $2.9 trillion to India’s annual GDP by 2025. For the nation to benefit from the demographic advantage, a healthy female workforce is vital; it can help to sustain its thriving economy.

Professor Vijay Pereira, second author on the paper, commented that the extent of the issue is huge and the Government of India has to implicate major policies to tackle the problem with better targeted campaigns.

He added: “What is clear is that the state healthcare sector must transform itself to deliver quality breast cancer healthcare and awareness underpinned by effective use of social marketing campaigns. This research presents several proposals that would assist health marketers working in India’s emerging economy.”