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A study presented at the European Society for Medical Oncology Congress meeting
in October 2002 found that breast cancer treatment and survival rates in developing
countries depend greatly on a woman’s socio-economic status. In a study of women from
Pakistan, researchers found that those from higher income families generally receive
adequate treatment and have good chances of surviving breast cancer, while poorer women
often do not seek treatment out of fear of physical/emotion repercussions from their
families, poor advice from local physicians, or other factors. The study found that
treatment and survival were much lower among poor Pakistani women, underscoring the need
for greater healthcare education and improved access to quality treatment for these women.
In the study of 286 Pakistani women with breast cancer, Dr. Zeba Aziz from the Allama
Iqbal Medical College in Lahore, Pakistan analyzed several features of the women’s
cancers, including tumor size, when they were diagnosed, the treatment strategy, and
survival. Dr. Aziz then factored in the women’s socio-economic status to determine
whether it played a role.
Among the women from higher income families, nearly 75% were diagnosed with early stage
breast cancers and 89% received sufficient treatment for their disease. After 10 years, a
full 73% of these women were still alive. By comparison, 50% of the women from poor
families were diagnosed with advanced breast cancer, and
only 44% received sufficient treatment. As a result, 49% of the women from middle income
families and 22% of women from low income families were still living 10 years later.
According to Dr. Aziz, there were several reasons why poor women failed to seek
treatment until their breast cancer has progressed to an advanced stage, when treatment is
often less successful and the odds of survival are much lower. These reasons included
ignorance about the disease; many poor Pakistani believe that breast cancer is contagious.
"We have seen women being isolated to the point of not being allowed to touch their
children or use the household utensils," said Dr. Aziz, in a statement for the European
Society for Medical Oncology Congress meeting.
In addition, many people from low socio-economic backgrounds believe that breast cancer
is an unattractive disease, and many spouses leave wives who have been treated for the
disease. This fear of physical or emotion abandonment was another factor related to late
breast cancer diagnoses, as seen in the study. Dr. Aziz also said that some local
physicians do not understand the seriousness of breast cancer and do not advise women who
present breast lumps to seek treatment.
Breast cancer treatment is also unaffordable for many poor women in Pakistan. Only
one-tenth of Pakistanis have health insurance. Therefore, many women choose alternative
treatment strategies, such as meditation, in lieu of surgery and other standard
treatments.
Dr. Aziz said that education is key to improving breast cancer treatment and survival
in Pakistan and other developing countries. She also suggested that women participate in clinical trials. By removing the stigma associated with
breast cancer and improving access to adequate treatment, breast cancer survival could
improve dramatically in Pakistan.
Additional Resources and References
- The 27th annual European Society for Medical Oncology (ESCO) Congress
meeting was held October 18-22, 2002 in Nice, France. The October 21, 2002 news release,
"Stigma of Breast Cancer in Developing Countries Costs Lives," is available on
the ESCO website, http://www.esmo.org/
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