Breast cancer is the most common cancer among Indian women. Every four minutes a woman is diagnosed with breast cancer in India and every 13 minutes a woman loses her life to the disease.

Some of the factors responsible for this increase include lack of exercise, overweight-obesity, hormone replacement therapy, combined oral contraceptive pills and stress, among others.

It is also worrying that women in India with breast cancer tend to be diagnosed at more advanced stages when the prognosis is also poorer.

Some estimates suggest that nearly 50 percent of women with breast cancer first visit a doctor when their disease is at Stage 3.

If the disease is diagnosed early, surgery can prove to be an effective and curative intervention, however, at advanced stages, multiple interventions are usually required, including chemotherapy and radiation.

These not only make the treatment process more complex for patients who may have to contend with multiple side effects, but also increases the financial burden significantly.

Incidence rates of breast cancer vary widely within India perhaps due to differences in the education status of women, income levels, place of residence (urban versus rural), reproductive history, lifestyle factors and participation in screening programs.

Data released for 22 States and Union Territories as part of the National Family Health Survey-5 shows that a higher proportion of women underwent breast cancer screening in North-Eastern States like Mizoram, Manipur and Meghalaya as well as Maharashtra, Kerala and Himachal Pradesh.

It is important to collect and analyse such statistics at the national and sub-national levels on a regular basis in order to design more targeted strategies as well as achieve greater equity in access to and quality of screening efforts.

A major challenge in tackling breast cancer is lack of awareness, not necessarily about the disease per se, but more so about its risk factors, symptoms as well as diagnostic and treatment options.

Further, social stigma hampers the willingness and ability of women to engage in screening behaviours as well as seek diagnosis and treatment even after the appearance of symptoms.

It is only when women are aware of how their breasts normally look and feel can they alert health providers about any noticeable differences.

Last month, the Vice President launched a national breast cancer and benign breast disease helpline, an initiative of the Ushalakshmi Breast Cancer Foundation for raising awareness.

Behaviour change campaigns can be aided by the use of technology such as periodic reminders sent to the mobile phones of women for conducting breast self-exams and minimising controllable risk factors.

For women in their twenties and thirties, regular breast self-exams and clinical exams are recommended. When it comes to cancer, prevention is often not possible.

For women over the age of forty years, an ultrasound scan conducted as part of the annual health check-up can help facilitate early detection.

Regular mammograms are likely to be most beneficial for women older than forty years and with a family history of breast cancer.

Those with mutations in the BRCA1/BRCA2 genes or other genetic syndromes, however, should ideally be screened at younger ages and more frequently.

Disseminating information about breast cancer and universalisation of clinical exams should be a priority intervention at the Health and Wellness Centres (HWCs) being established under the Ayushman Bharat programme.

The referral pathways for women who are deemed to require further investigation post an initial assessment at the HWCs should also be clearly defined and simplified as much as possible.

Additionally, breast cancer patients whose surgeries or other types of treatment have been postponed must be tracked by the health system and provided the necessary care at the earliest possible.

This is imperative for minimising the downstream societal and financial costs that will otherwise need to be incurred on account of breast cancer cases remaining invisible to the health system or being detected only at very advanced stages.

(Author: Urvashi Prasad, Director, Development Monitoring & Evaluation Office, NITI Aayog

Disclaimer: Views expressed are personal.)