Breast cancer remains a significant public health challenge in India, with the National Academy of Medical Sciences (NAMS) recently highlighting critical gaps in cancer care in its Task Force Report on Breast Cancer in India. The report, prepared by NAMS—an advisory body to the Central government on health policy—provides an in-depth analysis of breast cancer trends, challenges, and ongoing efforts to improve diagnosis and treatment in the country.

Breast Cancer in India: Current Scenario and Key Challenges:

India records nearly 200,000 new cancer cases annually, with breast cancer identified as the most common malignancy among women. Unlike in high-income countries, where breast cancer is generally diagnosed early, Indian patients tend to present with more advanced stages of the disease. According to the report:

·         Over 60% of breast cancer patients in India are diagnosed at Stage 3 or 4, indicating late-stage disease.

·         In contrast, about 60% of breast cancer cases in the U.S. are diagnosed at Stage 0 (in situ) or Stage 1, when the disease is more treatable.

The late diagnosis significantly lowers survival rates and complicates treatment. The report attributes this delay to multiple factors, including poor awareness, lack of screening programs, and inadequate diagnostic services.

Delay in Seeking Medical Care

More than 50% of breast cancer patients in India experience a delay of over three months before seeking medical attention. This lag time exacerbates disease progression and reduces the chances of successful treatment. The report stresses that timely diagnosis and intervention are critical to improving outcomes.

Why Early Diagnosis Matters

Breast cancer, when caught early, is largely treatable. The NAMS Task Force notes that survival rates in India lag behind those in Western countries due to:

·         Late-stage presentation,

·         Delayed initiation of treatment,

·         Fragmented or inadequate treatment modalities.

Gaps in Cancer Care: Diagnostic and Treatment Shortcomings

·         Inadequate diagnostic services hamper early detection.

·         Treatment modalities are unevenly distributed, with specialized cancer centers concentrated in urban areas.

·         Lack of awareness among patients and health workers leads to delayed diagnosis and poor follow-up.

·         Fragmented care delivery results in patients dropping out before completing treatment.

Cancer Burden in India and Globally:

·         Asia houses 60% of the global population, accounting for 50% of cancer cases and 58% of cancer-related deaths worldwide.

·         India ranks third globally in cancer incidence, behind China and the United States.

·         The projected cancer burden in India is expected to reach 2.08 million cases by 2040, a 57.5% increase from 2020.

Union Budget 2025-26: Prioritizing Cancer Care

·         The Ministry of Health and Family Welfare received nearly Rs. 99,858.56 crore, covering health research and family welfare.

·         Plans to establish Day Care Cancer Centres in all district hospitals over the next three years, with 200 centres scheduled for 2025-26.

·         Customs duty exemptions on 36 lifesaving drugs for cancer and chronic diseases, aimed at reducing treatment costs.

·         Additional concessional duties and exemptions for critical medicines under patient assistance programs.

National Initiatives to Improve Cancer Care

1. National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)

NPCDCS is a flagship initiative under the National Health Mission focusing on non-communicable diseases (NCDs), including cancer. It targets the three most common cancers in India: oral, breast, and cervical cancer.

Key components:

·         Community-level cancer screening for early detection.

·         Awareness and health promotion through frontline health workers and digital platforms.

·         Strengthening infrastructure by establishing tertiary cancer centers and state cancer institutes.

Current infrastructure under NPCDCS includes:

·         770 District NCD Clinics,

·         233 Cardiac Care Units,

·         372 District Day Care Centres,

·         6,410 Community Health Centre NCD Clinics.

2. Strengthening of Tertiary Care for Cancer Scheme

This program aims to decentralize specialized cancer care by expanding tertiary cancer centers. Currently:

·         19 State Cancer Institutes (SCIs) and 20 Tertiary Care Cancer Centres (TCCCs) are operational.

·         The National Cancer Institute in Jhajjar and Chittaranjan National Cancer Institute in Kolkata serve as key hubs for advanced treatment and research.

3. Ayushman Bharat Yojana

Launched in 2018, this flagship health scheme provides universal health coverage, focusing on vulnerable populations. It covers chemotherapy, radiotherapy, and surgical oncology for cancer patients.

·         Over 90% of registered cancer patients have started treatment under this scheme by 2024.

·         It significantly reduces out-of-pocket expenses, enhancing financial protection.

Ayushman Arogya Mandir Initiative

By the end of 2023, this initiative established over 1,63,402 operational centers, which have conducted more than 10 crore breast cancer screenings. This massive outreach highlights the government’s commitment to early detection and widespread accessibility.

4. Health Minister’s Cancer Patient Fund (HMCPF)

Under the Rashtriya Arogya Nidhi, HMCPF offers financial aid of up to ₹5 lakh (max ₹15 lakh) for cancer treatment to below-poverty-line patients. The scheme supports treatment at 27 Regional Cancer Centres with ₹50 lakh revolving funds each.

5. National Cancer Grid (NCG)

Established in 2012, the NCG ensures standardized, high-quality cancer care across India. It comprises 287 member institutions, including cancer centers, research institutes, and advocacy groups.

·         Treats over 750,000 new cancer patients annually, covering more than 60% of India’s cancer burden.

·         Collaborates with Ayushman Bharat to provide affordable, evidence-based care.

·         Supports the National Digital Health Mission by helping develop electronic patient records.

Advancements in Cancer Research and Treatment

·         NexCAR19: Launched in April 2024, India’s first indigenous CAR-T cell therapy for blood cancers, developed in collaboration with IIT Bombay and Tata Memorial Centre. This therapy is affordable and accessible, reducing dependence on expensive imports.

·         Quad Cancer Moonshot Initiative: A partnership with the US, Australia, and Japan to eliminate cervical cancer in the Indo-Pacific through enhanced screening, vaccination, and research.

·         Expansion of ACTREC: The Advanced Centre for Treatment, Research, and Education in Cancer is expanding its facilities to accelerate clinical breakthroughs and advanced treatment.

Awareness Generation and Prevention

·         Community-level preventive activities under Ayushman Aarogya Mandir.

·         Media campaigns promoting healthy lifestyles and cancer awareness on National Cancer Awareness Day and World Cancer Day.

·         Funding for awareness programs via the National Programme for Non-Communicable Diseases.

·         National campaigns like Eat Right India and Fit India Movement encourage healthy eating and physical activity.

·         Ministry of AYUSH promotes yoga for holistic health.

Conclusion

The NAMS Task Force Report on Breast Cancer in India presents a clear picture: breast cancer is a growing challenge with unique obstacles, including late diagnosis, inadequate diagnostic services, and treatment disparities. However, India is also witnessing promising advancements through strengthened national programs, infrastructure development, innovative research, and focused government policies.

Early diagnosis and comprehensive care remain the most effective ways to improve survival rates. The report calls for urgent multi-sectoral collaboration to close gaps in cancer care and make quality treatment accessible to all. Given the rising cancer burden projected in the coming decades, India’s response today will determine the future health outcomes for millions.