Nova Weng - %22Early Breast Cancer Awareness & Prevention in China%22 (2016)

EARLY BREAST CANCER AWARENESS & PREVENTION IN CHINA

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Early Breast Cancer Awareness & Prevention in China: Their Effect Among Women

Nova Weng

University of California, Los Angeles

19 December 2016


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Abstract

Over the past twenty years, a growing number of breast cancer cases have emerged in both urban

and rural areas of central China. Currently, the country’s efforts to produce accessible means of

prevention screenings and physician appointments have not been enough to help young Chinese

women with the resources to effectively detect early signs breast cancer, resulting in limited

treatment options, higher mortality rates, and increased economic burdens in the future.

According to the latest Chinese Cancer Registry Annual Report, the rate of breast cancer cases

have increased two folds in comparison to the rest of the world, and has become the most

common cancer among the 1.3 billion women in China (Wang and Yu, 2015). Today, due to

gaping socioeconomic disparities, many families have battled the issue of inequitable distribution

of health care programs, lack of education in rural areas, and nationally funded mammogram

screenings in China.


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According to The World Health Organization in 2012, 187,000 new breast cancer

incidences have been diagnosed in China, which makes up more than 12% of the world’s new

breast cancer cases. Most of the occurrences have centered around urban regions of the country

approximately 47.79 cases per 100,000 women, which is twice as high as that in rural places

27.72 cases per 100,000 (Wang and Yu, 2015). However, the mortality rate caused by breast

cancer in impoverished locations have doubled in comparison to cities due to their lack of

mammogram screenings and education in early breast cancer awareness.

Between 19932008, researchers have scrutinized the rate of the yearly breast cancer

diagnoses in multiple crosssectional studies in the Shandong, Jiangsu, Hebei, and Tianjin

provinces, and discovered that the flat rate have spiked up to 3.78.9% (Wang and Yu, 2015).

Furthermore, 2010 China Chronic Disease and Risk Factor Surveillance System used the Kish

grid method of sampling by conducting a national selection of four random municipalities and

found a staggering variability of breast cancer prone women in junction with socioeconomic

status, education levels, marital status, medical insurance, and differing age groups. Women aged

60 and older had the lowest breast cancer screening participation even though the demographic is

shown to have one of the highest cases of breast cancer. Married women and those aged 3040

had the highest breast cancer screening participation, but those living in developed cities showed

a higher concentration of breast cancer incidences (Wang, 2013).

Analysts have conjectured that this rising trend may have resulted from the byproducts of

China’s growing urbanization and industrialization. Younger women aged 2555 in developed

areas are more susceptible to breast cancer. Compared to Western nations like the US, the mean

age of breast cancer afflicted women is much younger than that of American women and their 5


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year survival rate was less than 73%. One of the reasonings for this inclination is due to the

unequal ratio of cancer registry systems to the high population of women in China. In 2013, there

were only 249 health registries in China that specialize in cancer over a wide area of 31

provinces with more than 200 million people (15.42% of China’s population). However, in the

US, 96% of cancer patients are overseen by nationally funded programs such as the “National

Program of Cancer Registries” by Centers of Disease Control (NPCR) and the “Surveillance,

Epidemiology, and End Results” (SEER) health care systems. Additionally, existing cancer

health registries in China are not properly funded and developed as Western countries, or

growing fast enough to accommodate the rise in cancer cases.

Recently, researchers have found the unequal distributions of breast cancer cases in rural

and urban areas could originate from certain risk factors. For instance, a study by Hardefeldt

found that those who have contracted certain diseases such as Diabetes mellitus are shown to be

connected to a 1020% increase risk of breast cancer. This diabetes is overshadowed in China

and is not considered a major issue in the public health service even though there is a strong

correlation suggesting that the disease could lead to breast cancer. However, the lack of attention

and economic resources in China prevents women from gaining the assistance they need to

detect symptoms of the disease, lower risk factors, or get large scale prevention screenings.

Physiologically, Asian women have higher dense breast tissue than Western women, which

requires more equipment and technological advancements to detect cancer signs. Due to the

increased rate of Asian women showing a higher sensitivity of bypassing breast cancer

detections, culturally, many Chinese are skeptical of distributing funding to large scale screening.


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Currently, there is no governmentally protected law that requires breast cancer MRIs,

mammograms, or large scale followup appointments for women in China. Screenings have been

proven in the US and Sweden to reduce breast cancer related deaths by 20%. Also, China’s

Guangzhou and Shanghai screening programs have detected 84.1% of all breast cancer cases.

However, it is critical to note that China had once initiated a national breast cancer screening in

2005 but has since been stopped after 2 years due to the deficiencies in financial funding and fear

of misdiagnosis (Wang and Yu, 2015). 100,000 women were meant to go through mammograms

and ultrasounds, but it takes 120,000 RMB in each screening process to detect one breast cancer

case and more than 211,000 RMB for each early stage cases to cover China’s population of 652

million females. This is especially more expensive in highly inflated cities like Shanghai, and

more difficult for poorer areas to even access the equipment. On average, breast cancer screening

participation among Chinese women were low and varied with different age groups in

comparison to the West.

Analysts have predicted that there will be more than 2.5 million breast cancer cases by

2021 (Scowcroft, 2011). To prevent this, China must prioritize early detection and awareness as

the number one aspect in treating breast cancer and lowering mortality rates. It is found that

higher educated women and married women showed a 36.6% increase in participating in early

breast cancer screenings. But older women and those without proper medical insurance are seen

to have a much lower rate in participating in independent breast cancer screenings. Though

difficult, China must make is possible to access early breast cancer detecting resources and

improve breast cancer prevention awareness for all women, despite the disparities of

socioeconomic status, regional status, and age.


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References

Scowcroft, H. (2011, February 4). Why are Breast Cancer Rates Increasing? Retrieved from

http://scienceblog.cancerresearchuk.org/2011/02/04/whyarebreastcancerratesincreas i

ng/.

Wang Baohua (2013). Breast Cancer Screening Among Adult Women in China,

Preventing Chronic Disease. Retrieved from

https://www.cdc.gov/pcd/issues/2013/13_0136.htm

Wang, Fei and Yu, ZhiGang. (2015). Current Status of Breast Cancer Prevention in China.

Chronic Diseases and Translational Medicine, 1(1), 28.doi:10.1016/j.cdtm.2015.02.003.

Retrieved from http://www.sciencedirect.com/science/article/pii/S2095882X15000043

http://scienceblog.cancerresearchuk.org/2011/02/04/why-are-breast-cancer-rates-increasi

https://www.cdc.gov/pcd/issues/2013/13_0136.htm

Nova Weng - %22Early Breast Cancer Awareness & Prevention in China%22 (2016)

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