A preliminary IIT Madras survey in Chennai has found that nearly three in four women respondents had never undergone breast cancer screening, with many saying they had not sought screening because they had no symptoms. The findings have highlighted gaps in awareness, access and the design of preventive healthcare services for women in the city.
The survey was conducted by an IIT Madras team working with AIIMS Delhi as a prelude to an ICMR-supported project that aims to predict whether breast cancer has spread to armpit lymph nodes using ultrasound images. The survey findings were released during Pink October, the month observed internationally as Breast Cancer Awareness Month.
Of the 102 respondents, whose median age was 38, 75 said they had never been screened and 27 reported having been screened at least once. Among those who had not been screened, 45 cited the absence of symptoms as the reason.
Pradeeba Sridar, an assistant professor in IIT Madras’s department of medical sciences and technology, said the online survey was conducted to understand what prevented women from coming forward for screening. She said that many women, including those with postgraduate degrees, relied on symptoms before deciding to seek screening.
Awareness of breast cancer symptoms was uneven among respondents. While 72.5% recognised a lump or thickening as a possible symptom, only 45.1% identified skin redness or texture changes. Just 37.3% recognised peeling or scaling of the nipple or breast skin. Nearly one in four respondents did not recognise any of the six symptoms listed in the survey.
Doctors involved in the survey stressed that screening is intended for women who appear healthy and do not have symptoms, rather than only for those who notice a physical change. Dr Bagyam Raghavan, a Chennai-based senior consultant radiologist and former president of the Breast Imaging Society of India, said early detection could reduce the burden of treatment and make healthcare spending go further.
The survey also identified preferences that could influence how screening services are delivered. Three-quarters of respondents preferred a female healthcare provider. Raghavan said services would need to be affordable and available in locations where women could access them, with female doctors and technicians as well as privacy, dignity and comfort.
The findings come against a rising cancer burden among women in Tamil Nadu. State cancer registry data cited in the survey showed that breast cancer was the most common cancer among women in the state in 2023, accounting for about three in 10 new cases. Its crude incidence rate was 35.6 per lakh women, more than twice the rate for cervical cancer, which stood at 15.7 per lakh.
The registry recorded 49,225 new cancers among women in 2023, compared with 42,852 in 2019, an increase of nearly 15%. The figures underline the importance of preventive services, although the survey itself does not establish a causal link between the reported screening behaviour and cancer outcomes.
The researchers found that women with a family history of breast cancer and older women had higher odds of having been screened. They cautioned that these were associations and not proof of cause. The authors also acknowledged that the sample was small and that a larger study would be needed to represent women across Chennai.
The team suggested that insurers and employers consider including age- and risk-appropriate breast cancer screening with minimal out-of-pocket costs. The researchers said innovation in detection would need to be accompanied by better awareness, easier access and supportive policies if cancers are to be identified earlier.
