In India, breast cancer is a significant burden on a vast and fragmented healthcare system with limited or unequal access to screening opportunities and a scarcity of skilled healthcare professionals. Add to this the conservative nature of Indian society, where societal taboos make it harder to educate people about breast cancer risks, leading to delays in seeking medical help, and you have a growing problem at hand.

India’s Breast Cancer Burden

Let’s look at the numbers. The burden of breast cancer in India is substantial, with a projected 52.4% increase by 2040[1]. In urban areas like Delhi, Chennai, and Bangalore, age-adjusted incidence rates are notably high[2]. For instance, Delhi reported 41 cases per 100,000 women in 2012[7], highlighting the urban concentration of breast cancer cases. Additionally, about 61%[6] of patients are diagnosed at locally advanced and advanced stages, influencing the overall survival rate, which stands at 66% for Indian women, considerably lower than the 90% in the USA[1][3a].

The Shame Factor

Women grappling with the risk of breast cancer face a complex interplay of factors. The fear of social stigma, concerns about being abandoned by spouses, and worries about familial repercussions contribute to delayed healthcare-seeking behaviour[4]. This reluctance results in a significant portion of breast cancer cases being diagnosed at advanced stages.

Challenges in India’s Existing Healthcare Infrastructure

The biggest gap is the lack of organised screening, which means missed opportunities for early detection. The dearth of radiologists is also a critical bottleneck. With only approximately 20,000 radiologists serving a population exceeding 1.4 billion, the demand far outstrips the supply[5]. 

There is also a reliance on conventional methods, which when coupled with a lack of systematic screening and a national program, leads to late-stage diagnoses, limited treatment options, reduced chances of successful therapy, and higher mortality rates[2].

How AI Can Revolutionise the Screening Process

When there are so many variables at play in a fragmented landscape, what can AI possibly do, you might ask.

AI, when seamlessly integrated into the healthcare system, can significantly improve radiologists' efficiency in evaluating large volumes of mammograms. It can refine report specificity, cut down false positives, which in turn will reduce patient anxiety, and minimise unnecessary follow-up tests. This not only optimises the use of mammography machines but also lightens the radiologists' workload.

Alleviating the Public Health Cancer Burden with AI

Now, imagine an AI-powered mammography-based screening program that goes beyond just working faster. It becomes a game-changer for large-scale, affordable cancer screening, transforming how we approach public health. 

Unlike the usual methods in India, AI makes mammography screening not only cost-effective but also ensures a more precise process (less stress of false alarms), thereby making it easier for healthcare providers to reach more people.

This breakthrough in efficiency and patient care is a big step forward in creating more effective screening programs and improving health outcomes as well as public health efforts, especially in areas where there aren't enough radiologists. By weaving AI deeply into our public healthcare system, we can not only make things work better but also make breast cancer screening more accessible, for all women, everywhere.

Integrating AI at the Grassroots for True Impact

For AI to create a meaningful impact, it must be seamlessly integrated into the last mile of healthcare delivery. Our frontline healthcare providers, ASHA and Anganwadi workers, can help change how we talk to women about breast cancer and early detection at the community level.

While they may not have direct access to AI tools, they can play an important role in preparing communities for potential larger public health initiatives integrated with AI. They can dispel myths, break through cultural taboos and encourage openness, ensuring that breast cancer awareness and early detection become a reality, even in the most underserved communities.

In conclusion, the journey towards rethinking breast cancer awareness in India necessitates a multi-faceted approach. Beyond symbolic pink ribbons, it involves addressing deep-rooted taboos, strengthening the continuum of care, and embracing the potential of AI in revolutionising breast cancer screening. Only through such comprehensive efforts can we truly enhance awareness, accessibility, and affordability in the modern age.

National Center for Biotechnology Information, National Institute of Health, National Library of Medicine, Indian Express, LiveMint