Late diagnosis, limited access: Study sheds light on breast cancer burden in rural Punjab
Chandigarh: As breast cancer continues to be a major cause of illness and death among the women, especially in rural areas, a study has highlighted the urgent need for improved cancer care infrastructure and early detection programmes in these regions.
The findings call for a concerted public health response to ensure timely diagnosis and uninterrupted treatment, particularly in resource-limited settings.
Conducted at a community health centre in Abdal, Amritsar, the study provides a stark look into the treatment challenges faced by 200 breast cancer patients between 2021 and 2024. The retrospective analysis, led by G Singh from the National Health Mission, Amritsar, focused on patients aged 25 to 72 years who were managed with systemic therapies, including chemotherapy, hormonal therapy, and targeted treatments.
The findings reflect the critical role of systemic treatment in rural settings, while also exposing significant barriers to effective care.
Alarmingly, 65% of the patients presented with stage III or IV breast cancer, underscoring the prevalence of delayed diagnosis in underserved regions. Chemotherapy was administered to 80% of the patients, while 55% received hormonal therapy based on hormone receptor status.
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Targeted therapies such as HER2 inhibitors were provided to 30% of eligible patients.
Despite the availability of treatment, only 70% of patients adhered to prescribed systemic therapies. Factors such as financial constraints, lack of awareness, and transportation difficulties contributed to non-adherence. However, patients who completed treatment experienced notably better progression-free survival and quality of life.
The study – 'Systemic Treatments in Breast Cancer: A Community-Based Analysis from Rural Punjab' – stresses the urgent need for comprehensive, community-based interventions. These include early detection initiatives, patient education, financial support schemes, and stronger collaboration between rural health centres and tertiary care institutions.
Heavy burden
Punjab faces a rising burden of breast cancer.
The state has four population-based cancer registries located in Sangrur, Mansa, Mohali, and Patiala, collectively covering urban, semi-urban, and rural populations. According to data from these registries, the number of breast cancer cases in Punjab increased from 39,521 in 2021 to 42,288 in 2024 — a 7% rise. Breast cancer now accounts for 30% of all cancers among women in the state, with an age-adjusted incidence rate of 37.5 per 1,00,000 — the highest in the country.
In response to this growing health challenge, the Punjab govt launched an innovative Early Detection Programme (EDP) aimed at improving cancer outcomes in the rural areas. The initiative has already demonstrated success in increasing early-stage diagnoses of breast, cervical, and oral cancers.
Implemented in Sangrur and surrounding areas within a 50-km radius of the Homi Bhabha Cancer Hospital (HBCH) — a unit of Mumbai's Tata Memorial Centre (TMC) — the programme was specifically designed to address the high prevalence of late-stage cancer diagnoses in low-income communities.
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