Prevalence of breast cancer in rural population of Jaipur: a survey-based observational study

Breast cancer, a global health concern predominantly affecting women, recorded 2.3 million new cases and 685,000 deaths in 2020. Alarmingly, projections suggest that by 2040, there could be over 3 million new cases and 1 million deaths. To assess breast cancer prevalence in 24 rural villages within a 60 km radius of NIMS Hospital, Tala Mod, Jaipur, Rajasthan, North India 303,121. A study involving 2023 participants conducted initial screenings, and positive cases underwent further tests, including ultrasound, mammography, and biopsy. SPSSv28 analysed collected data. Among 2023 subjects, 3 screened positive for breast lumps. Subsequent clinical examination and biopsy identified 1 normal case and 2 with breast cancer, resulting in a prevalence proportion of 0.0009 or 98 per 100,000. This study helps fill gap in breast cancer prevalence data for rural Rajasthan. The results highlight a concerning prevalence of breast cancer in the rural area near NIMS hospital, emphasizing the urgent need for increased awareness, early detection, and better healthcare access. Challenges like limited resources, awareness programs, and delayed diagnosis contribute to this high incidence. To address this, comprehensive approach is necessary, including improved screening programs and healthcare facilities in rural areas. Prioritizing rural healthcare and evidence-based strategies can reduce the burden of breast cancer and improve health outcomes.

Breast cancer is characterized by the unregulated proliferation and division of aberrant cells within the mammary gland.These cells may form lump or appear as visible abnormalities on mammogram.While breast cancer can affect both men and women, it is significantly more common in women.In 2020, the World Health Organization (WHO) reported 2.3 million breast cancer diagnoses and 685,000 deaths worldwide.By the end of 2020, there were 7.8 million women who had been previously diagnosed with breast cancer within the past five years and were currently alive, establishing it as the most widespread type of cancer worldwide 1 .
A research conducted by the International Agency for Research on Cancer (IARC) and its partner institutions predicts the future impact of breast cancer in 2040, drawing on the burden observed in 2020.It estimates that

Clinical investigation
The final identification of the cancerous site was done through mammography and ultrasonography using Mammography System MAM-VENUS, ALLENGERS Medical Systems Ltd.Sector-34, Chandigarh, India, and E-CUBE 5 ULTRASOUND IMAGING SYSTEM ALPINIONO MEDICAL SYSTEMS CO., Ltd.Seoul Republic of Korea, 19-06-2018 respectively 7,8 .Biopsy was performed to have final diagnosis of breast cancer in participants with positive physical screening as per American Society of Clinical Oncology (ASCO) guidelines 10 .

Ethics
In accordance with the ethical principles outlined in the Declaration of Helsinki, the Institutional Review Board of NIMS University Rajasthan, Jaipur, granted clearance for the current study to proceed (approval number: NIMSUR/IEC/2022/349). Informed consent was taken from all the participants.

Statistical analysis
The IBM SPSS version 28.0 programme was used to analyse the data, and Excel version 2019.Descriptive statistical methods were used to encapsulate the data: continuous variables were presented using the standard deviation, mean, median, and category variables were expressed in frequency and proportion.The prevalence rate and prevalence proportion were calculated using the standard formula 11 .
The clinical examination of 3 subjects with positive physical screening is presented in Table 2. Subjects 1, 2, and 3 were 23, 44 and 50 years respectively.Subjects 1 and 3 were homemakers, subject 2 was farmer, and all three subjects were married.The age of menarche of subject 1, 2, and 3 was 12, 14, and 13 years, respectively, and the age of their first childbirth were 22, 18, and 22 years, respectively, and they had 1, 2, and 3 no. of children, respectively.Subjects 2 and 3 had history of breastfeeding, while subject 1 did not.Subjects 1 and 3 had symmetry in their breast shape, while the breast shape of subject 2 was asymmetric.The skin change was seen in subject 2, and the retraction in the breast and nipple was seen in subject 3, while the lymph node was enlarged in subject 2.
Of the 2023 participants physically screened, lump was found in 3 females, of which 2 were confirmed as breast cancer, yielding prevalence proportion of 2 (0.00098), and prevalence was 0.09%, which determined the prevalence rate 98 per 100,000 population.

Conclusion
In conclusion, the prevalence of breast cancer in the 60 km radius of NIMS hospital is a significant concern.The study has shed light on the alarming rate of breast cancer, emphasizing the need for increasing awareness, early direction, and improving access to health care services.In this study, the prevalence of breast cancer was found to be 0.0009 around 60 km of NIMS hospital covering 24 villages.Limited health resources, lack of awareness programs, and delayed diagnosis increase the risk of breast cancer.Addressing these challenges required multifaceted approaches, improving screening programs, and establishing comprehensive healthcare facilities.By investing in these initiatives and prioritizing the well-being of individuals residing in rural areas, we can work towards reducing the burden of breast cancer and improving overall health outcomes for these communities.Government authorities must implement evidence-based strategies to ensure that rural areas receive the necessary resources and support to combat breast cancer effectively.

Table 1 .
Descriptive data of all the enrolled patients.