"Role of Asymmetric Information on Breast Cancer in India. The Role of Awareness on Breast Cancer diagnosis and treatment in Urban India"
The goal of my project was to explore the effectiveness of distributed information and social stigmas towards trends in breast cancer diagnosis and treatment in urban India. In the past decade, the incidence of breast cancer in India has rapidly increased from 12% to 24%. In addition, the characteristics of breast cancer appear to be slightly different from the West, with Indian cases demonstrating early onset, short disease free interval and high mortality. Case studies done in major metropolitan areas like New Delhi, Mumbai, and Bangalore show that a significant population of women does not seek early detections, lack awareness, and are unwilling to take immediate action that cause these deviating trends. Increasing awareness is therefore the key to treating cancer in India more effectively. During the summer of 2007 I flew to India to investigate the reasons why women shy away from early detection that would save many lives. My hypotheses was that a lack of well formulated awareness in combination with social stigmas induced by this insufficiency leads women to evade preventative and diagnostic steps that could increase life expectancy through earlier detection and treatment of breast cancer.
To test this hypothesis, I traveled to Bangalore, the 3rd most affected city, where I worked under direct supervision of Dr. Sanjiv Sharma, the Head of Department of Radiology Oncology at the private Manipal Hospital. During my stay, I interviewed about 20 oncologists and feminine care professionals to acquire the professional opinion and information on specific efforts being made towards reducing Breast cancer fatality. I also spoke several local women and collected 160 surveys from the female population between the ages 30 and 65 to assess their behavior and opinions. Furthermore, I shadowed Dr. Sharma and some of his colleagues at three different hospitals throughout my trip to observe patient behavior, doctor-patient relationship, and overall medical conduct to get a better idea of the health system in India. Part of my observational experience included visiting the largest public cancer center in the city, Kidwai Memorial Institute of Oncology. This institute allowed me to ride along with the doctor conducting free satellite health care missions for women. Also, as part of my project, I compiled and distributed copies of a pamphlet containing basic information on breast cancer and available resources to as many people as I could, including all those surveyed. Several copies and a soft copy of the pamphlet were left with the oncology department at Manipal for further distribution.
The overall rough conclusion from my experience is that there is a large gap between relevant information that exists among the professionals and the general public. Most of the medical care seems to be targeted towards intensive care over preventative care which becomes an important factor in maintaining this gap. Poverty and over-population also play a vital role in limiting the attention given to information distribution and promoting prevention. When looking at educated middle class women, attitude struck as the determining factor when it came to prevention. For example, many of the candidates did not think they were vulnerable, or many admitted to having limited knowledge on breast cancer but did not demonstrate any active efforts to seek more information.
I am in the process of processing and analyzing my data. My surveys are based on the Health Belief Model that organizes such behavioral studies' data into four categories: perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. The final analysis paralleled with the doctors' opinions should present more substantial and statistically expressible results.
The final product of my project would, hopefully, provide a model that could be used to increase cancer related awareness in cities like Bangalore more efficiently. Of course, larger and more controlled studies need to be done to formulate a concrete model. My study is just a small step to get a better idea of attitudes, behaviors, and practices related to breast cancer in urban women of India. Having a better idea about what influences the preventative and information seeking behavior of these women may provide a direction to focus improvement initiatives for information dispersion.