BREAST CANCER: EARLY DETECTION INITIATIVE IN PAKISTAN

Female breast cancer is currently the most prevalent cancer worldwide, with estimated global figures of 2.3 million new cases (11.7% of all cancer) in 2020. It is the 5th leading cause of cancer-related mortality worldwide, 685,000 deaths.1,2 Exact cause of the breast cancer is not known however, genetic factors like BRCA 1, 2 & p 53 gene mutations play an important role. Other risk factors include female gender, growing age, high estrogen exposure, obesity, lack of exercise, stress, early menarche and late menopause etc.3 Magnitude of the breast cancer patients in Pakistan is undetermined due to absence of the central registry.4 However, an estimated 90,000 women are diagnosed every year with breast cancer in Pakistan out of which 40,000 die every year.5 It’s said that every 9th woman is at risk of breast cancer in Pakistan, nevertheless, being a woman, every woman is at risk.5,6 Recently activities initiated by the first lady, national & international organizations and civil society to raise the awareness about self-examination and early detection in Pakistan has highlighted the importance of this health problem to the masses. Pakistan Atomic energy commission (PAEC) is the prime stakeholder of the cancer care in Pakistan. PAEC cancer registry report 2018-2019 encompassed the data of cancer patients from all over Pakistan including & Afghan refugees. According to this report, breast cancer was the most common cancer (8,816- 23% and 9,827- 24% cases during 2018 & 2019 respectively) among female of Pakistan. Most common age of reporting of the cancer remained 49 years, compare to 62 years in USA.7 The high-risk group was 40-69 years of age, comprising of about 90% of the breast cancer. According to this data every two out of five females were diagnosed with breast cancer in Pakistan. Highest number of breast cancer patients were seen in Punjab (49% in 2018 & 50% in 2019) and Islamabad (45% in 2018 & 46% in 2019), reasons may include urban life, enhanced awareness and availability of the diagnostic facilities in these areas. Rest of the breast cancer statistics include: Sindh (34.6% in 2018 & 34.0% in 2019), KP (31.1% in 2018 & 34.0% in 2019), Baluchistan (28.8% in 2018 & 30.7% in 2019), Jammu and Kashmir (34.1% in 2018 & 35.0% in 2019), Gilgit Baltistan (25.0% in 2018 & 19.2% in 2019) and Afghanistan (29.2% in 2018 & 34.4% in 2019). According to the data, since 2015, out of 41,673 total breast cancer patients, 939 (2.2%) males mostly from the Pukhtoon eth