October 17, 2013 — Women with breast cancer in African countries often grapple with dangerous delays in diagnosis and treatment because of scant resources, societal stigma about the disease, and incompetence and corruption in the health care system, the New York Times reports. According to the Breast Health Global Initiative, incidence of and death rates from breast cancers will increase by more than 50% over the next two decades in developing countries.
Because of attention to more "acute" health threats in Africa -- such as malaria and AIDS -- cancer has long been neglected on the continent, the Times reports. However, in 2011, the United Nations began a worldwide campaign against noncommunicable diseases, such as cancer, diabetes, heart disease and lung disease. The Times notes that 7.6 million people worldwide die of cancer each year and that 70% of such deaths occur in low- and moderate-income countries, according to the World Health Organization.
Lack of Information, Treatment Deadly for Many
In Africa, breast cancer is one of the most deadly forms of cancer. Many women do not have access to accurate information about cancer, lack the funds for treatment or are unable to get to quality health care facilities. As a result, most women in Africa with breast cancer are diagnosed at stage 4 -- the final, least-treatable stage -- when the cancer already has spread to bones and organs.
When women do seek treatment, mastectomy often is the only option offered because most doctors do not have the technology to ensure a lumpectomy is done properly.
Experts noted that if doctors in African countries had better information and tools, breast cancer could be detected earlier -- giving women a greater chance of survival. For instance, if physicians could detect a cancer at stage 3 instead of stage 4, they could increase a woman's odds of survival by 30%, according to the 2012 World Breast Cancer report.
Benjamin Anderson, head of the Breast Health Global Initiative, said, "The terrible part about breast cancer is that if we just did what we already know how [to] do in other places, we could make major shifts in survival."
However, most breast cancer specialists agree that those strategies should not include screening programs similar to those in higher-income countries, the Times reports. There are not enough trained health workers to perform or read the scans. Instead, resources should be used to help women with palpable lumps that can be detected without mammograms.
In an effort in Uganda, U.S. experts are working with doctors on strategies to increase "downstaging" -- finding tumors in earlier stages, when they are more treatable. For example, the experts are teaching Ugandan doctors to use ultrasound machines to examine lumps that women have noticed and identify which ones might need urgent treatment (Grady, New York Times, 10/15).