65% of women’s cancer deaths preventable: Lancet study

A majority of annual female cancer deaths could be prevented through early detection and prevention strategies, a Lancet report said this week.

Titled “Women, Power, and Cancer,” the study said that 1.5 million of the 2.3 million women who lose their lives prematurely to cancer each year could be saved through such measures.

An additional 800,000 lives could be saved if all women worldwide had access to optimal cancer care, it added.

The unequal distribution of power in society adversely affects how women engage with cancer prevention, care, and treatment. Despite facing a cancer burden similar to men, women experience greater suffering due to gender disparities. The report notes that in almost every country, including India, cancer ranks among the top three leading causes of premature death in women.

When we look at the health ecosystem, women interact with cancer in various ways – not only as people living with cancer but also as unpaid caregivers, individuals participating in cancer prevention and screening at the national level, healthcare providers, researchers, and policymakers.

Dr Ishu Kataria, senior public health researcher at the Center for Global NCDs, RTI International and commissioner on the Lancet Commission, noted that in this context they face gender bias and discrimination on multiple fronts, be it due to their age, ethnicity, socio-economic status, gender identity or sexual orientation. This hinders their ability to seek good quality care for both diagnosis and treatment.

Moreover, even when women have access to quality cancer care, they are at a higher risk of facing financial pressures from the disease, which can have severe implications for their families. The study employs an intersectional feminist perspective to explore not just the biological aspects of cancer, but also its interconnected gender-related socioeconomic, environmental, cultural, and political dimensions.

According to Dr Kataria, the political dimension of gender in health research and health care system has received little attention and has been subjected to patriarchal and colonial forces.

“To advance a more nuanced and inclusive approach to the cancer field and transform the ways women in all their diversities interact with the cancer health system, both as patients and care providers, cancer care must be approached as an intersectional feminist issue. The Commission sets out a new intersectional feminist framework which challenges existing asymmetries of power in relation to cancer: in decision-making, knowledge, and economics,” she added.

A case study from India featured in the report tells the story of a 36-year-old woman from Nala Sopara in Mumbai. After consulting a local doctor for continuous headaches and vomiting, she was misdiagnosed and told to get spectacles. Eventually, she was diagnosed with brain cancer. Despite her health struggles, her alcoholic husband disregarded the need for basic medical consultation and allegedly subjected her to physical abuse. Fortunately, her father-in-law ensured she received the necessary medical attention.

The woman was married at 16 to a man 15 years her senior. She has since given birth to two daughters, now 18 and 13, and a five-year-old son.

Data from India’s National Cancer Registry Programme for 2020 indicate that breast, cervical, and ovarian cancers remain the primary causes of cancer-related fatalities among Indian women.

Dr Kataria also noted that awareness drives regarding cancer in India are being carried out but not in a systematic manner.

For instance, when HPV vaccination which prevents cervical cancer was introduced in Sikkim, they conducted a 6-month sensitization drive to educate all stakeholders which resulted in great uptake of the vaccine. Only if such things happen systematically in a streamlined manner with consistent and accurate messaging, they would be helpful, she said.

Tobacco use is the second most significant risk factor, contributing to 6% of cancer-related deaths. The burden of tobacco-related cancers varies significantly by gender—12% for women compared to 36% for men—aligning with the global prevalence of tobacco smoking where women are more often exposed to second-hand smoke.

Alcohol consumption and obesity each played a role in 1% of cancer mortality in India.