February 11, 2013 | The Editors

Breast cancer: a global health issue

Three women, wearing matching blue vests and nametags, link arms and smile for the camera. Photo: PATH/Tara Hayes Constant.
Peruvian health promotoras educate women about breast cancer. Photo: PATH/Tara Hayes Constant.

Guest contributor Amie Bishop is a senior program director at PATH who leads our efforts to address breast cancer.

On World Cancer Day last week, I attended a global summit convened by the new international division of one of the most prominent breast cancer advocacy groups in the United States, Susan G. Komen for the Cure. Yes, the international division. The group’s increased focus on women outside of the United States signals, I believe, a rising call: it’s time for the global health community to do something about breast cancer, a scourge that is perceived—incorrectly—as largely a worry for women in wealthier countries.

The meeting was star-powered, serious, and heart-wrenching. Data and stories from around the world made clear that addressing breast and cervical cancer in low- and middle-income countries is a moral imperative of our time, no less important than the commitment years ago to turn back the epidemic of HIV in hardest-hit countries.

Cancer is the biggest killer

Consider this: cancer today accounts for more deaths worldwide than tuberculosis, HIV, and malaria combined. Breast cancer is the most common cancer among women—it will afflict an estimated 9.1 million women in poorer countries over the next decade. Of the 5 million women expected to die from breast cancer in the next decade, 70 percent will live in low- and middle-income countries.

Due  to lack of services, poor access to the care that might exist, and scant information about breast health, women in poorer countries are far more likely to progress to advanced disease than women in the United States and Europe. In Uganda, more than half of women with breast cancer are diagnosed with advanced cases. In Kenya, the percentage is nearly all women diagnosed. Late diagnosis vastly reduces their chances of survival. And tragically, the women destined to die often lack access to palliative care, including medication that, for pennies, could relieve their suffering.

Breast cancer’s moment?

This moment in the story of breast cancer resonates with me for a couple of reasons. I was part of PATH’s early work on cervical cancer prevention, and my colleagues and I can now look back with great satisfaction at the remarkable progress that has been made against that disease. I was also involved in PATH’s first breast cancer assistance program, in Ukraine. At that time, many questioned why we should focus precious resources on breast cancer. In fact, our work broke ground in using existing resources to reach women and their medical providers.

Today, PATH is one of a few organizations testing new approaches to breast cancer in low- and middle-income countries. We’re focusing on Peru, bringing breast cancer early detection, diagnosis, treatment, and support services closer to women in their communities. We plan to begin similar work soon in East Africa.

Next: noncommunicable diseases

The world is slowly waking up to the need to address noncommunicable diseases, including cancer, in low- and middle-income countries. The momentum is growing to tackle barriers to diagnosis and care, and there’s broad recognition that the cost of inaction will be staggering.

PATH and others are pushing to identify low-cost approaches for early detection in the absence of mammography. We’re also aiming to develop low-cost methods of diagnosis and tumor evaluation so that treatment can be targeted effectively.

The key will be to integrate strategies and interventions into existing systems, develop strong partnerships within countries and across the world to find out what works, and, most important, to ensure that innovations are sustainable in local communities.

Sounds like an ideal challenge for PATH.

More information

•   Our Reproductive Health website.
•   Susan G. Komen for the Cure website.

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