Breast cancer is the most common cancer worldwide, and the leading cause of cancer death among women. Additionally, breast cancer deaths disproportionately affect individuals in low- and middle-income countries. Breast cancer 5-year survival rates in high-income countries exceed 90%, compared with 66% in India and 40% in South Africa.

 What explains global inequities?

• Late diagnosis: Detection at advanced stages greatly reduces chances of survival
• Inadequate services: Insufficient diagnostic and treatment infrastructure
• Low coverage: Failure to comprehensively include breast cancer in the country’s essential health benefit package and the universal health coverage agenda

Several, high-income countries have seen significant declines in breast cancer mortality rates, year-on-year, for 2 decades. But the 40% reduction in breast cancer mortality seen in high-income countries since the 1980s is yet to be achieved in the majority of low- and middle-income countries.

Effective strategies

Countries with high breast cancer survival rates are characterized by increased levels of its coverage in essential health benefit package and strengthening the health system building blocks towards achieving improved access to services across the continuum of care.

Bridging inequities in breast cancer outcomes requires systematic improvements in access to resource-appropriate and quality services. Among countries achieving sustained mortality reductions, most breast cancer cases are diagnosed at an early stage, reinforcing the value of effective early detection programmes for improving breast cancer outcomes.