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Indian Journal of Cancer, Vol. 46, No. 3, July-September, 2009, pp. 252-253 Letter To Editor Lack of awareness about breast cancer and its screening in developing countries Rizwan MM, Saadullah M Department of Internal Medicine, Prince George's Hospital, 3001 Hospital Drive, Cheverly, MD 20785 Code Number: cn09060 PMID: 19574687 Sir The data presented by Patra [1] represents a holistic picture about the state of breast cancer awareness in developing countries. Because of other compelling healthcare issues, breast cancer is not regarded as a health care priority and cancer awareness programs are either nonexistent or dysfunctional in the third world. Just to give a quick comparison, 75% of the women conduct Breast Self Examination (BSE) in the United States, [2] in contrast only 30.3% of the females from Saudi Arabia have even heard of BSE. [3] In Iran 1402 women were interviewed recently and only 61% of the respondents knew about breast cancer. [4] Similarly, awareness about breast cancer screening in Pakistan can be accessed from the fact that only 14% of the mammography tests performed in the country′s leading cancer institute were for a screening purpose. [5] In most of the developing countries the incidence of breast cancer is currently low, but rapid industrialization, westernization of lifestyle, urban development, an increase in life expectancy, and delayed and reduced fertility are some of the factors responsible for increasing the incidence of breast cancer and it seems that the incidence will continue to grow in the years to come. Similar to Patra, [1] many other researchers have identified television as the leading medium of information. However, low literacy rates call for more effective and targeted media campaigns. Public service messages should be broadcasted using credible celebrities to convey the message in a culturally appropriate manner that resonates with target population. Novel channels of delivery such as prime time television melodramas, situational comedies, commercials, and the Internet should also be explored. Product advertising studies show that the effects of mass media campaigns tend to be of a short duration, hence, these strategies should be best used in combination with other approaches. Training social workers, school teachers, and others who are regarded as trusted agents of the community could go a long way. Treatment of early disease is less resource intensive and has excellent outcomes, underscoring the importance of promoting early detection in low and middle income regions. However, resource constrains lead to limited applications of breast healthcare guidelines developed for western nations. Due to the high cost of mammography, lack of necessary infrastructure, and the fact that the peak incidence in India and neighboring countries is in the younger population, usefulness of mammography as a screening tool is questionable. For countries like India, it seems logical to consider clinical breast examination and BSE as a screening modality; however, there is an urgent need to establish a screening protocol. It has been asked that low income countries should come together and develop a common ground for measures to reduce breast cancer rates and practice economically feasible and culturally compatible diagnostic and therapeutic modalities. [6] References
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