Indian-American 'Unseen & Overlooked' Amid Breast Cancer Risk: Study

In the past few years, breast cancer has emerged as one of the most common cancers affecting women in the US. It contributes to approximately 16% of the total diagnosed cases of cancer. While there has been a general improvement in the detection and treatment of cancer that has reduced mortality rates, not all segments of the population have benefited equally from these advances.

Recent studies and expert opinions point to a disturbing trend that Indian-American women are at a rising risk for developing breast cancer, yet remain unscreened, underserved, and invisible. 

Rising Incidence – Especially Among Younger Women

Breast cancer was once considered a health threat that only older women faced. However, a new study by the Breast Cancer Research Foundation found that the rates for this cancer are rising more among women under 50, especially among the larger group known as Asian-American Pacific Islander (AAPI), which includes Indian-American women.

In some segments of this group, the rates for this cancer have risen by more than 50% between 2000 and 2021. While the rising rates of this cancer worry researchers, Indian-American women remain invisible.

This is because they are typically grouped under the larger “Asian American” umbrella in most health data, making it difficult to identify specific patterns, risk levels, or screening gaps for this subgroup. 

Why Risk Is Growing Among Indian-American Women

Experts have identified a variety of factors that have contributed to the growing risk of breast cancer in this demographic population; these factors include:

• When Indian-origin women immigrate to another country, their lifestyle and cultural practices change. This may include changes in eating habits, lack of exercise, delayed childbearing, shorter duration of breastfeeding, and increased duration of exposure to estrogen. All these changes may increase the risk of breast cancer.
• Biological factors, such as breast density, also play a role in the occurrence of breast cancer. Women of Asian descent, such as Indian-Americans, have dense breast tissue. Dense breast tissue not only increases the risk of breast cancer but also makes early detection of breast cancer difficult through routine mammograms.

Screening Disparities and the “Hidden” Risk

Although the risk is higher, the use of mammography is still lower in AAPI women than in many other groups in the US. The CDC also states that approximately 54% of AAPI women aged between 40 and 49 years had a mammogram in the last two years compared to approximately 78.5% of women in the US aged between 50 and 74 years who had the same experience.

The importance of early detection lies in the fact that the best odds of successful treatment are found in screening methods, with mammograms and clinical breast examinations being the best methods.

If breast cancer is diagnosed before any symptoms appear, during the localised stage, the prognosis is good for successful treatment.

If no screening is conducted, breast cancer is diagnosed later, which reduces the probability of survival and increases the difficulty of treatment.

Cultural and Structural Barriers

Experts observe that Indian-American women have lower breast cancer screening and preventive care rates than the general US population. Several factors contribute to this phenomenon:

• Indian-American women lack visibility in statistics, and their risk factors are not apparent.
• There is a taboo associated with breast cancer among Indian women, and any conversation related to this topic is considered uncomfortable.
• Indian-American women, being first-generation immigrants, lack knowledge of the US healthcare system and seek treatment only when symptoms appear.
• The relationship with healthcare is reactive in the Indian-American culture, meaning that people visit the hospital only when they have a problem, rather than seeking healthcare for the sake of prevention.

All the above factors may allow the rising health risk in the population to go unnoticed.

Addressing the Gap: Solutions and Recommendations

Experts in health matters argue that effective progress can result from working on different fronts at the same time. These fronts include:

• Improve the collection and interpretation of health data. Health agencies should start collecting health data specifically about Indian Americans, instead of using race. This will show the number of people from the Indian American community who are actually affected by breast cancer.
• Improve education and outreach efforts. Education and outreach efforts that are in line with the cultural background of the people in the community may reduce the stigma associated with breast health and emphasise its importance in the lives of the people in the community.
• Improving access to health screening. The community can benefit from mobile health screening services. These services can help in eliminating structural barriers to health screening.
• Improving health conversations. The health community can benefit from leaders who are able to talk about health in general and, in particular, about breast health. These conversations can help in changing attitudes regarding health.

Although there are great advances in early detection and treatment, which have saved many lives, Indian-American women are not benefiting from these advances. They are not being targeted in health programs, and there are cultural factors that contribute to their suffering from this deadly disease.