In a global effort to raise awareness on breast cancer, October has been designated as the Pink Month.

The Pink Month is a month where efforts to educate those concerned about the disease, including early identification and signs and symptoms associated with breast cancer. To commemorate 2015 Pink Month, the WHO Ethiopia Staff Association (WESA) organized a breast cancer awareness session for women staff where breast self-examination techniques were taught by Dr Fikir Melese, WESA Chairperson.  The orientation included updates on the current situation of cancer in Ethiopia, and prevention of breast cancer.

October is observed across the world as the month of breast cancer awareness. It is among the most prevalent cancers in the world, and the most common in women. According to the WHO, Breast cancer became the most common cancer globally as of 2021, accounting for 12% of all new annual cancer cases worldwide.

Though awareness about the disease in Pakistan has witnessed an improvement in urban areas where there is greater education and better health facilities, not much has changed for the rural poor who can only turn to understaffed and ill-equipped dispensaries or Basic Health Units for medical assistance. A number of public and private buildings have been lit up pink this month, while the government has also launched an awareness campaign via a recorded message on mobile networks. But that is not enough.

The government should launch a nation-wide free screening campaign in collaboration with private hospitals, at least in the month of October, for the early detection of new cases. The assurance that female medical staff would conduct the screening may encourage more women to get themselves checked. A national cancer registry is also needed so that all cases become part of the public record for effective policymaking.

The statistics are frightening. Every year, some 90,000 cases of breast cancer are detected in Pakistan, the highest rate in all of Asia. Sadly, about 40,000 of these patients will die. 109 women die every 24 hours due to breast cancer in Pakistan.  In the rural areas, there is even more stigma surrounding the issue, and female gynaecologists are not always easily available. Moreover, while the average age worldwide of breast cancer patients is 55 years, the median age in Pakistan is 35 years, which is a truly alarming gap. It makes sense for us to strip away the misconceptions and stigma surrounding the disease and make an honest appraisal of how our attitudes are putting so many lives at risk.

The American Cancer Society’s update on female breast cancer statistics in the United States, including population-based data on incidence, mortality, survival, and mammography screening. Breast cancer incidence rates have risen in most of the past four decades; during the most recent data years (2010–2019), the rate increased by 0.5% annually, largely driven by localized-stage and hormone receptor-positive disease.

In contrast, breast cancer mortality rates have declined steadily since their peak in 1989, albeit at a slower pace in recent years (1.3% annually from 2011 to 2020) than in the previous decade (1.9% annually from 2002 to 2011). In total, the death rate dropped by 43% during 1989–2020, translating to 460,000 fewer breast cancer deaths during that time.

The death rate declined similarly for women of all racial/ethnic groups except American Indians/Alaska Natives, among whom the rates were stable. However, despite a lower incidence rate in Black versus White women (127.8 vs. 133.7 per 100,000), the racial disparity in breast cancer mortality remained unwavering, with the death rate 40% higher in Black women overall (27.6 vs. 19.7 deaths per 100,000 in 2016–2020) and two-fold higher among adult women younger than 50 years (12.1 vs. 6.5 deaths per 100,000).

Black women have the lowest 5-year relative survival of any racial/ethnic group for every molecular subtype and stage of disease (except stage I), with the largest Black–White gaps in absolute terms for hormone receptor-positive/human epidermal growth factor receptor 2-negative disease (88% vs. 96%), hormone receptor-negative/human epidermal growth factor receptor 2-positive disease (78% vs. 86%), and stage III disease (64% vs. 77%).

By Vavek Bharwani

Zealous technologist, writing enthusiast and an activist