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Oncologist Perspectives on Breast Cancer Screening in India-Results from a Qualitative Study in Andhra Pradesh

  • Bodapati, Srikanthi Lakshmi (Indian Institute of Public Health) ;
  • Babu, Giridhara Rathnaiah (Public Health Foundation of India)
  • Published : 2013.10.30

Abstract

Background: It is important to understand the perceptions of oncologists to understand the comprehensive picture of clinical presentation of breast cancer. In the absence of clear evidence, clinical practice involving patients of breast cancer in India should provide insights into stages of breast cancer with which women present to their clinics and mode of screening of breast cancer prevalent in Andhra Pradesh. Materials and Methods: A qualitative study was conducted to understand the perceptions of oncologists regarding clinical presentation of breast cancer, stages at which women present to clinics, and mode of screening of breast cancer prevalent in Andhra Pradesh. In-depth interviews (IDI) were conducted with ten practising oncologists from various public and private cancer hospitals in Hyderabad city to understand their perspectives on breast cancer and screening. The data were triangulated to draw inferences suitable for the current public Health scenario. Results: Late presentation was indicated as the most important cause of decreased survival among women. Most women present at Stage 3 and 4 when there is no opportunity for surgical intervention. The results indicate that there is a huge gap in awareness about breast cancer, especially in rural areas and among poor socioeconomic groups. Even despite knowledge, most women delay in reporting due to reasons like fear, embarrassment, cost, ignorance, negligence, and easy going attitude. Conclusions: It is important to improve awareness about breast cancer and screening methods for promoting early screening. The study inferred that it would be beneficial to establish cancer registries in rural areas. Also, the policymakers need to make key decisions which among three methods (breast self examination (BSE), clinical breast examination and mammography) can best be used as a screening tool and how to successfully implement population wide screening program to prevent mortality and morbidity from breast cancer in India.

Keywords

Breast cancer screening;oncologists;factors causing breast cancer;preventive measures;Andhra Pradesh

References

  1. Babu GR (2009). Cancer incidence rates among South Asians in four geographic regions: India, Singapore, UK and US. Int J Epidemiol, 38, 1157-8. https://doi.org/10.1093/ije/dyn119
  2. Babu GR, Samari G, Cohen SP, et al (2011). Breast cancer screening among females in iran and recommendations for improved practice: a review. Asian Pac J Cancer Prev, 12, 1647-5.
  3. Babu GR, Srikanthi BN, Jotheeswaran AT (2013). Epidemiological correlates of breast cancer in South India. Asian Pac J Cancer Prev, [Epub ahead of print].
  4. Calle E, Heath C, McMahill M, et al (1996). Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53,297 women with breast cancer and 100,239 women without breast cancer from 54 epidemiological studies. Lancet, 347, 1713-7. https://doi.org/10.1016/S0140-6736(96)90806-5
  5. Gajalakshmi V, Mathew A, Brennan P, et al (2009). Breastfeeding and breast cancer risk in India: a multicenter case control study. Int J Cancer, 125, 662-5. https://doi.org/10.1002/ijc.24429
  6. Chong P, Krishnan M, Hong C, Swah T (2002). Knowledge and practice of breast cancer screening amongst public health nurses in Singapore. Singapore Med J, 43, 509-6.
  7. Chopra R (2001). The indian scene. JCO, 19, 106-1.
  8. Friedenreich CM, Cust AE (2008). Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects. Br J Sports Med, 42, 636-7. https://doi.org/10.1136/bjsm.2006.029132
  9. Gakwaya A, Kigula-Mugambe J, Kavuma A, et al (2008). Cancer of the breast: 5-year survival in a tertiary hospital in Uganda. Br J Cancer, 99, 63-7. https://doi.org/10.1038/sj.bjc.6604435
  10. Goel A, Seenu V, Shukla N, Raina V (1995). Breast cancer presentation at a regional cancer centre. National Med J India, 8, 6.
  11. Kamarana N, Kamat M, Kurkure A (2003). National Can Registry Project, 2000. ICMR.
  12. Meshram I, Hiwarkar P, Kulkarni P (2009). Reproductive risk factors for breast cancer: a case control study. Online J Health Allied Scs, 8, 5.
  13. Okonkwo QL, Draisma G, Der Kinderen A, et al (2008). Breast cancer screening policies in developing countries: a cost-effectiveness analysis for India. J Natl Cancer Inst, 100, 1290-0. https://doi.org/10.1093/jnci/djn292
  14. Sabu K, Pattanshetty S, Darshan B, Kamath S (2010). Problem of breast cancer in South India: a record based study. Austr Med J, 3, 972.
  15. Saxena S, Chakraborty A, Kaushal M, et al (2006). Contribution of germline BRCA1 and BRCA2 sequence alterations to breast cancer in Northern India. BMC Med Gen, 7, 75.
  16. Thomas DB, Gao DL, Ray RM, et al (2002). Randomized trial of breast self-examination in Shanghai: final results. J Natl Cancer Inst, 94, 1445-7. https://doi.org/10.1093/jnci/94.19.1445
  17. Sharif F, Abshorshori N, Tahmasebi S, et al (2010). The effect of peer-led education on the life quality of mastectomy patients referred to breast cancer-clinics in Shiraz, Iran 2009. Health Qual Life Outcomes, 8, 74. https://doi.org/10.1186/1477-7525-8-74
  18. Smith RA, Caleffi M, Albert US, et al (2006). Breast cancer in limited resource countries: early detection and access to care. Breast J, 12, 16-6. https://doi.org/10.1111/j.1075-122X.2006.00185.x
  19. Takiar R, Vijay C (2010). An alternative approach to study the changes in the cancer pattern of women in India (1988, 2005). Asian Pac J Cancer Prev, 11, 1253-6.
  20. Wiseman M (2008). The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proc Nutr Soc, 67, 253-6. https://doi.org/10.1017/S002966510800712X

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