Pakistan has the highest rate of breast cancer in Asia and latest demographic trends suggest that this rate is likely to further increase in the coming years. Diagnosis of breast cancer at an early stage has a significant impact on reducing both morbidity and mortality. Mammographic screening is also linked with a variety of socio-cultural and economic factors.
However, women in Pakistan tend to approach health facilities at the last stage of cancer due to plethora of socio-economic and cultural factors such as: age, employment status, lack of awareness, fear of surgery, and belief in traditional treatments, and spiritual healing.
In Pakistan, 89% of breast cancer patients are diagnosed at later stage and 59% at an advanced stage due to lack of awareness. The fear of stigmatization and feminine sensitivity limits the choice of treatment and early detection of breast cancer in low and middle income countries. In addition, physical barriers also become a source of psychosocial stress, as patients show hesitancy to undergo the exhausting screening and treatment process. In the context of Pakistan, only a handful studies have explored the reasons behind delay in cancer screening and treatment such as lack of awareness [18], poor socioeconomic status , availability and affordability of cancer medicine [19], and risk factors (exposure to hazardous industrial substances) There is a dearth of studies on the impact of socio-cultural beliefs and their impact on delayed breast cancer screening and treatment in Pakistan. A few studies have investigated the patient’s knowledge about breast cancer in Punjab, effects of social support in adjustments with breast cancer, handling and managing of breast cancer and delayed presentation of breast cancer.
In Contrast, present study has used qualitative method to explore the fears and barriers of diagnosis and treatment of breast cancer. A unique feature of this study is to simultaneously unearth individual, sociocultural and structural barriers that prevent women to seek timely diagnosis and treatment of breast cancer in Punjab. It has explored the dimensions of breast cancer experience that are scant in existing literature.
Recently, the Supreme Court of Pakistan expressed grave concern about the high prevalence rate of breast cancer in Pakistan. According to the World Health Organization (WHO), Pakistan is facing the lowest life expectancy rate in Asia, which is 67.48 years. On the other hand, our mortality rate is skyrocketing and the main cause for this is breast cancer among women. It accounts for 40,000 deaths along with a diagnosis of 90,000 new cases per year. Breast cancer is curable if diagnosed at an early stage and can be easily detected by routine examinations. Yet one out of nine women in Pakistan is suffering from this disease. This is because of a lack of awareness and stigma related to diseases associated with women. Women are often unaware of the need for regular examinations and hesitant to get themselves examined.
Given the high prevalence of the disease, it is imperative that women are informed of breast cancer and prevention methods. Hospitals should collect data on the disease and the successes of treatments, which should be utilised in campaigns to raise awareness. Women should be encouraged to examine themselves whenever they detect any changes in their bodies. There is an urgent need to destigmatise breast cancer because it has already risked the lives of many women. All relevant authorities and medical practitioners must come together to limit the spread and prevalence of breast cancer. An early diagnosis and effective treatment will also lift the burden of the medical system that is already under considerable strain due to several diseases.
Neelam Yasir
Karachi
