5-yr breast cancer survival rate in India stands at 66.4%: ICMR study

New Delhi: The five-year survival rate for breast cancer, the most common cancer in India, stands at 66·4 per cent, with variations across 11 geographical areas, according to a study led by the Indian Council of Medical Research (ICMR).

Breast cancer is the most common cancer in India, accounting for 28.2 per cent of all female cancers, with an estimated 216,108 cases by 2022.

The age-standardised incidence rate of female breast cancer has increased by 39.1 per cent from 1990 to 2016, and this trend has been seen in every state of India over the past 26 years.

The study, published in Cancer, an international interdisciplinary journal of the American Cancer Society, showed disparity in survival rates across 11 geographical areas.

Mizoram (74.9 per cent), Ahmedabad urban (72.7 per cent), Kollam (71.5 per cent), and Thiruvananthapuram (69.1 per cent) had higher survival rates than the national average.

Conversely, Pasighat (Arunachal Pradesh) had the lowest survival rate (41.9 per cent). Manipur and Tripura also had low survival rate, while the national average stood at 66.4 per cent.

Deaths during the 5-year follow-up period were also the highest in Pasighat (53.6 per cent) and lowest in Mizoram.

"Breast cancer survival in India has improved slightly, but it still lags behind that in developed countries. Comprehensive cancer control strategies have to be implemented widely in the country," said the researchers including Krishnan Sathishkumar, from ICMR’s National Center for Disease Informatics and Research, along with others.

"Early detection programmes, including breast cancer awareness and cost-effective screening, along with accessible and affordable multimodality treatment, survivorship care, and palliative care, have to be prioritised," they suggested.

The study included 17,331 patients who had breast cancer diagnosed between 2012 and 2015 from 11 areas who were followed until June 30, 2021. The team conducted survival analysis by calculating the difference between the date of first diagnosis and the date of death or censoring to estimate observed survival and relative survival.

The study also revealed that Indian patients diagnosed with local-stage cancer have a 4.4 times greater 5-year survival rate than those diagnosed with distant-stage cancer. In addition, patients older than 65 years had a 16 per cent lower chance of survival compared with those aged 15-39 years.

Further, the study found that the survival rates for localised, locoregional, and distant metastases in India were lower than those in the US, with rates of 81.0 per cent, 65.5 per cent, and 18.3 per cent, respectively, compared with 99.3 per cent, 86.3 per cent, and 31.0 per cent, respectively.

In India, the majority of patients with breast cancer were diagnosed at the locoregional stage (57 per cent) in contrast to the US, where large numbers of cases were identified at the localised stage (63 per cent).

In light of the disparity, "it is imperative to implement comprehensive cancer control strategies widely throughout the country", the team said.

"Newer treatment options, such as targeted therapies and immunotherapies, have been shown to improve the prognosis of certain subgroups of patients with breast cancer, but access to such expensive choices are extremely limited in a low-income to middle-income country like India," they noted.