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Breast cancer screening (BCS) in India: understanding challenges and opportunities by applying systems and complexity thinking


Breast cancer is one of India’s leading health issues, with the number of cases increasing year after year. This health threat has surpassed the incidence of cervical cancer, which was previously the leading cancer in the country. Despite the launch of a landmark nationwide cancer screening program in 2016, India recorded 1.8 million new breast cancer cases in 2019 with 90,408 fatalities in 2020, straining the country’s health systems. These fatalities were estimated to be twice as high as in the United States, indicating low participation in these programs, making Indian women more likely to have insufficient screening and receive late diagnosis. Among the nation’s many health priorities, coverage for breast cancer screening is extremely suboptimal, necessitating special policy considerations. This review highlights some key challenges and opportunities for advocating and employing systems and complexity thinking in cancer screenings, as well as how a holistic and cultureoriented approach could improve program participation and coverage. These considerations may eventually lead to improved health outcomes as well as sustainability and resilience in the country’s complex socio-political eco-system.


breast cancer screening, Indian government, awareness, health care professionals