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A study presented at the European Society for Medical Oncology Congress meeting in October 2002 found that breast cancer treatment and survival rates in developing countries depend greatly on a woman’s socio-economic status. In a study of women from Pakistan, researchers found that those from higher income families generally receive adequate treatment and have good chances of surviving breast cancer, while poorer women often do not seek treatment out of fear of physical/emotion repercussions from their families, poor advice from local physicians, or other factors. The study found that treatment and survival were much lower among poor Pakistani women, underscoring the need for greater healthcare education and improved access to quality treatment for these women. In the study of 286 Pakistani women with breast cancer, Dr. Zeba Aziz from the Allama Iqbal Medical College in Lahore, Pakistan analyzed several features of the women’s cancers, including tumor size, when they were diagnosed, the treatment strategy, and survival. Dr. Aziz then factored in the women’s socio-economic status to determine whether it played a role. Among the women from higher income families, nearly 75% were diagnosed with early stage breast cancers and 89% received sufficient treatment for their disease. After 10 years, a full 73% of these women were still alive. By comparison, 50% of the women from poor families were diagnosed with advanced breast cancer, and only 44% received sufficient treatment. As a result, 49% of the women from middle income families and 22% of women from low income families were still living 10 years later. According to Dr. Aziz, there were several reasons why poor women failed to seek treatment until their breast cancer has progressed to an advanced stage, when treatment is often less successful and the odds of survival are much lower. These reasons included ignorance about the disease; many poor Pakistani believe that breast cancer is contagious. "We have seen women being isolated to the point of not being allowed to touch their children or use the household utensils," said Dr. Aziz, in a statement for the European Society for Medical Oncology Congress meeting. In addition, many people from low socio-economic backgrounds believe that breast cancer is an unattractive disease, and many spouses leave wives who have been treated for the disease. This fear of physical or emotion abandonment was another factor related to late breast cancer diagnoses, as seen in the study. Dr. Aziz also said that some local physicians do not understand the seriousness of breast cancer and do not advise women who present breast lumps to seek treatment. Breast cancer treatment is also unaffordable for many poor women in Pakistan. Only one-tenth of Pakistanis have health insurance. Therefore, many women choose alternative treatment strategies, such as meditation, in lieu of surgery and other standard treatments. Dr. Aziz said that education is key to improving breast cancer treatment and survival in Pakistan and other developing countries. She also suggested that women participate in clinical trials. By removing the stigma associated with breast cancer and improving access to adequate treatment, breast cancer survival could improve dramatically in Pakistan.
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