‘Many women still present with advanced disease’: AIIMS doctor on India’s breast cancer survival gap

India’s estimated five-year breast cancer survival rate of 65.7% reflects gaps across the cancer care continuum, not just treatment, according to Abhishek Shankar, assistant professor of radiation oncology at AIIMS. ‘Survival has improved with community-based screening and Ayushman Bharat-PMJAY, but many women still present with advanced disease due to low awareness, stigma, financial barriers, and delays in diagnosis,’ he said.

Shankar added that disparities in access to pathology, imaging, radiotherapy, systemic therapy and follow-up care, especially between urban and rural areas, continue to affect outcomes. ‘Strengthening early detection, timely diagnosis and equitable access to quality treatment is essential to improve survival,’ he said.

His comments follow the World Health Organization’s first country-wise breast cancer survival estimates, published in Nature Medicine, which put India’s five-year survival rate for women diagnosed during 2017-2021 at 65.7%, against a global median of 77.8%. Survival reaches 87.3% in high-income countries, 88.5% in the WHO region of the Americas and 84% in the European region.

A 2024 National Cancer Registry Programme study had already shown a similar trajectory, with India’s five-year survival rising from 31-54% among women diagnosed in the 1990s to 66.4% for those diagnosed during 2012-2015 — an improvement researchers said still leaves room for progress through earlier diagnosis and better access to quality cancer care.

The WHO study is the first to estimate five-year breast cancer survival across all 194 member states, giving countries a baseline against the WHO Global Breast Cancer Initiative’s goal of cutting premature breast cancer mortality by 2.5% a year and saving 2.5 million lives by 2040.

Breast cancer is now the most common cancer among women in 158 countries and caused an estimated 6.9 lakh deaths globally in 2024, with nearly 70% occurring in low- and middle-income countries, the WHO said, noting that the stage at diagnosis remains one of the strongest predictors of survival.