A recent Associated Press article by Asif Shahzad grabbed my attention. Women in Pakistan not only suffer the highest rate of breast cancer in Asia, but the majority is completely ignorant of the disease!

Breast cancer is the leading cancer killer among adult Pakistani females, according to World Health Organization official Shahzad Aalam. About 40,000 women succumb to the breast cancer each year. Aalam stated that the disease is rampant.

Numerous challenges contribute to the disturbing rate of breast cancer incidences in a developing country such as Pakistan.

Cultural Taboos

Taboos in a conservative, Islamic culture significantly hinder the awareness and understanding of the mere existence of the disease called breast cancer. For example, a breast cancer awareness group called Pink Ribbon Pakistan found that they were forbidden to say the word “breast” during a presentation to a Pakistani university. In lieu of the words “breast cancer,” the Pink Ribbon group was reportedly required to use the neutral (and misleading) term “cancer of women” when discussing self-examinations and mammograms.

Sadly, when Pakistani women are diagnosed with breast cancer, they often refrain from sharing the information from their families, even their husbands. The word “breast” is associated with sexuality, not health. Furthermore, many consider undergoing a medical screening to be immoral.

Deplorable Healthcare

The poor state of Pakistan’s healthcare sector also contributes to the detection of breast cancer. The lack of adequate funding, current technology, and medicine only adds to the hindrance of breast cancer diagnosis and treatment. According to oncologist Saira Hasan at the Shifa International Hospital in Pakistan’s capital city of Islamabad, most major hospitals lack a mammogram facility. Consequently, many women are diagnosed with breast cancer in its later, harder-to-treat, stages, leading to higher mortality rates.

Alarming Vitamin D Deficiency

The landscape of medical literature is awash with studies linking vitamin D deficiency to an increased risk of developing breast cancer. I therefore was not surprised to identify research that revealed high incidences of vitamin D deficiency among Pakistani women:

Researchers at Aga Khan University in Karachi, Pakistan studied 305 premenopausal females living in the Karachi area to determine, inter alia, the prevalence of low vitamin D. Over 90 per cent of the participants were vitamin D deficient with trace amounts equivalent to about 1 ng/mL. This study was published in the December 2012 issue of the journal Archives of Osteoporosis.

–Issued in the March 2011 publication of the International Journal of Gynecology & Obstetrics, another Karachi study examined full term, pregnant women and their newborns to understand the prevalence of vitamin D deficiency. About 89 per cent of the Pakistani moms and their newborns were deficient in vitamin D.

Bright Lights in the Dark

Strict cultural taboos, poor healthcare, and high incidences of vitamin D deficiency contribute to the rising increase of breast cancer in Pakistani women.

The encouraging news is that breast cancer awareness and detection are increasing in Pakistan, with a number of active supportive groups. For example, Pink Ribbon Pakistan not only launched a mobile mammogram clinic but runs free national breast screening programs in 12 cities.

Perhaps the brightest light of hope belongs to breast cancer survivor and prominent Pakistani politician Fehmida Mirza. In a recent interview with the Associated Press, she emphatically stated, “There’s nothing to be shy about it. No woman, no woman should die of ignorance and negligence.” Mirza uses her position in Parliament to advocate women’s health issues. She intends to propose a legislative bill to require Pakistani women to undergo annual breast cancer screenings and mammograms as well as to teach young women about self-examination.

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