Awareness and a rising need for improved breast cancer screening

This October, the global community once again observes Breast Cancer Awareness Month, also known as Pink October, at these times when the need for expanded awareness and wider access to screening for and treating breast cancer is sought.

Breast cancer is a type of cancer where cells in the breast multiply abnormally. It can be detected through self-breast examination and screening.

While men can get diagnosed with breast cancer, the disease is more common in women. According to the Philippine Cancer Society (PCS), the following risk factors contributing to breast cancer include among others, age (higher incidence at a higher age), genetic risk factors, family history, not having children or having them later in life; as well as lifestyle factors such as alcohol, being overweight or obese, and exercise.

According to the International Agency for Research on Cancer (IARC), breast cancer became the most commonly diagnosed cancer type in the world in 2020. Breast cancer was also found to be the most common cause of cancer death in women, and the fifth most common cause of cancer death overall.

During the said year, IARC found that about 2.26 million women were diagnosed with breast cancer, and about 685,000 women died from the disease.

Here in the Philippines, breast cancer is the most common type of cancer in women, according to the Department of Health (DoH).

As noted by a study by the Philippine Statistics Agency (PSA) in 2019, the Philippine Society of Medical Oncology (PSMO) reported that three out of 100 Filipino women are estimated to develop breast cancer before the age of 75. It was also noted that breast cancer accounts for 15% of all new cancer cases and 8% of all cancer deaths in the country.

In addition, the Philippine Obstetrical and Gynecological Society found that the Philippines had the highest prevalence of breast cancer among 197 countries in 2017. World Health Organization (WHO), in its Cancer Country Profile 2020, said that breast cancer is considered the most common type of cancer in the Philippines and has the highest incidence rate of 17.6%.

​These figures just show how crucial it is for women to self-examine and then get screened for breast cancer and so get treated upon detection of the disease.

According to the United Kingdom-based organization Breast Cancer Now, self-examination can be done in three steps: touching one’s breasts for feeling anything unusual, looking for changes in appearance, and checking for any changes with a general practitioner. On its website, our very own PCS has a guide on how to self-examine the breasts for any symptoms.

The WHO affirms that early detection of breast cancer affects survival rates, and when the disease is identified early the treatment can be more highly effective.

However, access to breast cancer screening and treatment is found to be not uniformly high globally, which means that survival from breast cancer gets compromised in some countries or regions.

“There are substantial disparities in survival between more-developed and less-developed countries, as well as between different social groups within countries. These disparities are due in part to reduced access to early diagnosis and timely completion of treatment,” the IARC, which is part of WHO, explained in a statement on its website.

A study recently published in the journal Preventive Medicine Reports in October highlighted the current challenges in screening breast and cervical cancers in the Philippines.

The study highlighted that most Filipino breast and cervical cancer patients are diagnosed with late-stage disease, and several factors have contributed to these late diagnoses.

“[M]ajority of breast and cervical cancer patients are diagnosed at advanced stages, as high out-of-pocket healthcare costs, the centralization of health human resources and infrastructure in the capital, and the absence of organized national screening programs preclude access to breast and cervical cancer screening,” the study noted.

Sociocultural factors also contribute to low screening uptake for women’s cancers, the study recalled. Such factors include poor knowledge of cancer screening, fatalistic attitudes toward cancer, and stigma associated with a cancer diagnosis, such as the perception that mammography is a painful experience.

The authors of the study found that the passage of the Universal Health Care Law and the National Integrated Cancer Control Act provides an opportunity to reduce disparities in access to cancer screening.

“This begins with investing in organized cancer screening programs, collaborating with multiple stakeholders on community-based educational campaigns, and addressing the social determinants that underlie women’s cancers,” the authors wrote.

Several brands, hospitals, and institutions are observing Breast Cancer Awareness Month through various promos, deals, and other initiatives. The PSMO, for its part, has begun its online breast cancer education this month. Its Abot Kamay Ako at Ang PSMO (AKAP) program currently offers free breast cancer education for patients, caregivers, patient support, and cancer advocates. Those interested in availing of this free learning program can visit https://psmo.org.ph/psmo-online-payments/lay-breast-cancer-101-online-registration/. — Adrian Paul B. Conoza