According to WHO, breast cancer survival rate in India is lower than in wealthy countries

According to the first country-level estimates published by the World Health Organization (WHO), the survival rate for breast cancer in India is gradually increasing, but only about two out of three women diagnosed with the disease survive for at least five years. This underscores the critical need for timely diagnosis and treatment.

Comparative Survival Rates

According to WHO estimates, the five-year survival rate for breast cancer among women in India diagnosed between 2017 and 2021 was 65.7%. This figure lags behind the global median of 77.8%. In high-income countries, survival reaches 87.3%, while the WHO reports 88.5% in the Americas region and 84% in the European region.

Scope of the Study and Initiatives

This study is the first to assess the five-year survival rate for breast cancer across all 194 WHO member states. It provides countries with a baseline benchmark to measure progress within the WHO Global Initiative to Combat Breast Cancer. The goal of this initiative is to reduce premature mortality from breast cancer by 2.5% annually and save 2.5 million lives by 2040.

Progress and Challenges in India

Previous Indian studies have also shown improvements in survival rates. A National Cancer Registry study for 2024 indicated that the five-year survival rate increased from 31–54% among women diagnosed in the 1990s to 66.4% for those diagnosed between 2012 and 2015. Nevertheless, researchers note that India still has potential for improvement through earlier diagnosis and better access to quality cancer care.

Barriers to Improvement

Abhishek Shankar, an assistant professor of radiation oncology at AIIMS, noted that the 65.7% five-year survival rate in India reflects gaps across the entire cancer care continuum, not just in treatment itself. He added that despite improvements due to community-level screening and the Ayushman Bharat-PMJAY program, many women present with advanced forms of the disease due to low awareness, stigma, financial barriers, and diagnostic delays. Issues with access to pathology, imaging, radiotherapy, systemic therapy, and follow-up care, especially between urban and rural areas, continue to negatively affect treatment outcomes. He emphasized that strengthening early detection, timely diagnosis, and equitable access to quality care is essential for improving survival.

Regional Differences and Global Statistics

The WHO report revealed significant disparities in survival rates across different regions and income groups, linked to variations in early detection, timely diagnosis, and access to care. The median five-year survival rate was 87.3% in high-income countries, compared to 78.7% in upper-middle-income countries, 60.1% in lower-middle-income countries, and 41.9% in low-income countries.

Overall Breast Cancer Situation

In 2024, breast cancer became the most common type of cancer among women in 158 countries, causing approximately 6.9 lakh deaths worldwide, with nearly 70% of these cases occurring in low- and middle-income countries. The WHO stated that survival largely depends on early diagnosis and timely access to surgery, radiotherapy, and cancer drugs, with the stage of the disease at diagnosis remaining one of the strongest predictors of survival.

www.aajtak.inJuly 9, 05:10

Delhi Rule Prevents Financial Aid for Cancer Patients Treated at AIIMS

Cancer patients in Delhi are facing difficulties in obtaining financial support due to an existing rule by the Delhi government. Patients receiving treatment at the National Cancer Institute (NCI) at AIIMS Delhi cannot receive financial assistance of 500,000 rupees from the Delhi Arogya Kosh fund.

Reason for Denial of Aid

The Delhi government claims that the AIIMS National Cancer Institute is located in Jhajjar, Haryana. Based on this argument, it is asserted that patients receiving treatment there are not entitled to benefits under this program. However, in similar cases, other states, including Uttar Pradesh, provide full financial support to their residents even if they receive treatment in hospitals in other states.

The Story of Asha

Although the National Cancer Institute is part of AIIMS Delhi, it is situated in Jhajjar. Nevertheless, many Delhi residents do not receive financial aid from Delhi Arogya Kosh. For instance, 48-year-old Asha from Rohini, who is battling late-stage breast cancer, began treatment at the National Cancer Institute (NCI) at AIIMS in Jhajjar. After undergoing all necessary examinations and prescriptions, doctors advised her to start additional treatment with a special drug requiring annual injections. However, for the past eight months, she has not been able to receive a single injection because she has not received the 500,000 rupee amount from Delhi Arogya Kosh.

Cost of Treatment and Seeking Help

NCI AIIMS doctors recommended the drug TDM-1 to Asha last year, which required multiple administrations over the course of a year. Since the cancer had spread to other parts of the body, the doctors prescribed this medication. As this injectable drug is unavailable in government hospitals, it must be purchased independently, and the cost of an annual dose is 1 million rupees. Due to this high amount, Asha's family could not afford the drug. Asha's daughter, Nisha, applied for financial assistance from the Prime Minister's National Relief Fund and Delhi Arogya Kosh. Although funds from the PM Fund were received, the funds from Delhi Arogya Kosh did not arrive. The money from the PM Fund allowed for several months of injections, but now, due to the lack of funds, treatment has been suspended for the last eight months.

Family's Position and Official Responses

Nisha stated that injections are not being administered to her mother at NCI due to lack of money. This is why she approached Delhi Arogya Kosh, but her application was rejected. One official explained over the phone that the Delhi Arogya Kosh funds are only intended for patients whose treatment takes place in Delhi hospitals. Nisha emphasized that they have lived in Delhi for many years and are in a severe financial situation as she has no father, and her brother works selling goods by the roadside. Despite this, the money for her mother's injections from Arogya Kosh has still not arrived. Although the main treatment continues at AIIMS NCI, doctors warn that without timely injections, the treatment will be useless, and her mother's condition is critical as the cancer has spread throughout her body.

Situation of Another Patient

Like Asha, Vandana from Narela, Delhi, suffered from breast cancer, and her treatment was also taking place at AIIMS NCI. Her husband, Sandeep Kumar, reported that although standard medications and chemotherapy were administered at AIIMS NCI, doctors recommended 11 injections over the year for further treatment. The cost of one injection was about 50,000 rupees, totaling 550,000 rupees. Since he works as a taxi driver, collecting such a sum proved impossible. Sandeep applied to the Prime Minister's National Relief Fund and Delhi Arogya Kosh. He received about 250,000 rupees from the PM Fund, which allowed for some injections, but he received no funds from Delhi Arogya Kosh. After numerous appeals to officials and letters to the Member of Parliament in the Delhi government, he only received promises. He was also told that since AIIMS NCI is not in Delhi, aid from Delhi Arogya Kosh would not be provided. After long efforts, when the money did not arrive, he borrowed 400,000 rupees from relatives to treat his wife. Now his wife is healthy, but follow-up care continues at AIIMS Jhajjar.

Information on Delhi Arogya Kosh

Delhi Arogya Kosh is a state medical program of Delhi that provides financial assistance to low-income residents of Delhi for treatment in Delhi state or central government hospitals. This program provides financial support (non-cash) of up to 500,000 rupees for medical services such as treatment for serious illnesses, surgeries, and expensive examinations in government hospitals. This service applies to treatment in Government of Delhi, Central Government, AIIMS, and autonomous hospitals. The state covers expenses up to 500,000 rupees directly to the hospital. People with an annual income of up to 300,000 rupees who have resided in Delhi for the last three years can receive this aid.

Specialists' Comments

According to a senior doctor at AIIMS Delhi, patients registered at AIIMS Delhi utilize the Arogya Kosh program, but patients treated at AIIMS NCI do not receive financial assistance, even though NCI Jhajjar is part of AIIMS Delhi. The outpatient record in Jhajjar also lists AIIMS New Delhi. After the establishment of NCI, many cancer patients from Delhi register at AIIMS Jhajjar. Nevertheless, they are denied aid, citing that the institution is not located in Delhi. Meanwhile, if a patient comes from another state, such as Uttar Pradesh or Bihar, they receive financial assistance from their state's CM Fund. Moreover, daily more than 100 cancer patients are referred from AIIMS Delhi to AIIMS Jhajjar. Some of them are registered in Delhi, but their treatment takes place in Jhajjar and they receive aid, while local patients registering at NCI remain without support.

Medical Community Reaction

According to information received from the Delhi Ministry of Health, the response to this issue should be provided by the Directorate of Information and Public Relations (DIP) Delhi. A senior DIP employee, Manish, stated that the 500,000 rupee financial aid is provided to low-income patients treated in central and Delhi hospitals. However, according to the rules, AIIMS Jhajjar is not part of the National Capital Territory of Delhi, so patients treated at AIIMS NCI Jhajjar do not receive aid from Delhi Arogya Kosh. Jotsna Govil, president of the Indian Cancer Society in Delhi, noted that she understands the difficulties faced by low-income patients, and that constant visits to doctors and interaction with officials exacerbate their difficult situation. She added that if such patients approach the Indian Cancer Society, the organization provides some financial assistance within its limited resources, and hopes that no one will be deprived of timely treatment due to administrative barriers. Dr. Rohan Krishnan, patron of the Federation of Indian Medical Associations, stated that such rules should be changed because they create major problems for cancer patients, and that aid should be provided at AIIMS Jhajjar if the patient is from Delhi and low-income, as it is part of AIIMS Delhi.