According to GLOBOCAN, the Global Cancer Observatory under the World Health Organization, which monitors the cancer burden worldwide, breast cancer is the most common cancer in the world. In India alone over 1.9 lakhs new cases of breast cancer was reported in 2022 contributing to 13.6% of all cancer cases combined. This roughly translates to 1 woman being detected with breast cancer every 4 minutes. Reportedly, by the end of 2022, over 5.25 lakh women were alive in India having been diagnosed with breast cancer in the previous five years. Globally breast cancer incidence is increasing at an annual rate of 3.1%. It is also estimated that by the year 2040, the incidence of new cases worldwide will reach over 30 lakhs. Most of these cases would be reported in economically developing countries in Asia and Africa.
Breast cancer in India is diagnosed at a much younger age than in the West. Over 50% of breast cancer affects women in the 25-50 age group and most of these cancers are reported at an advanced stage compared to the West. One of the main reasons attributed to this is India is predominantly composed of a younger population compared to the West. Over 80% of the Indian population is less than 50 years old. It is a well-known fact that the risk of breast cancer increases with increasing age. This means the incidence of breast cancer will be steadily rising annually as the overall age of the population also increases.
According to Dr Sredharan M, Consultant – Onco-Surgery, Manipal Hospital, Goa, the risk factors for breast cancer can be classified into non-modifiable risk factors such as increasing age, inherited genetic risk factors, and family history of breast cancer, and modifiable risk factors such as lifestyle factors. Changes in lifestyle especially globalization and the urbanization of rural India can be attributed to the increasing breast cancer incidence in India.
Obesity/overweight increases the risk of breast cancer possibly by increasing the estrogen level and by causing insulin resistance and oxidative stress to the body. Obesity in India has reached epidemic proportions due to easy access to unhealthy processed foods post-globalization. Prolonged sedentary workstyle pattern and long hours of sitting with minimal physical activity increases the risk of obesity and hence the risk of breast cancer.
Eating a healthy diet, one that is focused on fruits, vegetables, and whole grains, and reducing processed food to a minimum is important. Any regular physical activity like walking, cycling, dancing, yoga, etc. helps in keeping the weight under check. While more easily said than done, it is important to incorporate at least 30 minutes of regular physical activity into the daily schedule. The adoption of Western lifestyles has increased the habit of smoking and alcohol drinking among women, especially in metropolitan cities. Apart from increasing the risk of breast cancer, this can increase the risk of oral cavity cancer, colon cancer, heart disease, and stroke.
Since the Industrial Revolution, the participation of women in the workforce has gradually risen and many are in high status and well-paid occupations. Naturally, this has increased the age of marriage and the age at first childbirth due to occupational and societal pressure. The decision to not have a child or to avoid breastfeeding is also seen commonly. Nulliparity, first childbirth after 35 years of age, and absence of breastfeeding increase the risk of breast cancer by 20-40%.
Breast cancer screening tests like mammography after 50 years of age and self-examination are especially important for those with a family history of cancers and it is important to discuss the pros and cons of these tests with the oncologist. Like in most illnesses, especially for cancers, prevention is always better than cure.
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