A Growing Concern

Breast cancer is now the most commonly diagnosed cancer among Indian women, surpassing cervical cancer in recent years. The GLOBOCAN 2020 report revealed that India recorded over 178,000 new breast cancer cases and more than 90,000 deaths, making it a public health crisis in the making. In Delhi/NCR, a region that uniquely combines advanced urban settlements with semi-urban and rural belts, the impact of this disease is amplified by stark differences in lifestyle, access to healthcare, and awareness.

The Urban vs. Rural Reality

Urban areas in Delhi/NCR show a higher reported incidence of breast cancer, largely due to a combination of delayed childbirth, sedentary work environments, increasing levels of obesity, and dietary habits dominated by processed foods. Women in urban spaces often have better access to diagnostic facilities, yet are simultaneously exposed to risk factors such as environmental pollutants, chronic stress, and hormonal therapies.

In contrast, the rural population reflects a paradox. On one hand, recorded incidence rates are lower, which might seem promising. However, these figures are often misleading due to underdiagnosis, lack of awareness, and cultural stigmas that prevent women from seeking timely medical care. Women in rural Delhi/NCR are more likely to ignore symptoms or delay medical consultation, influenced by limited healthcare infrastructure and financial constraints. A 2022 study by AIIMS indicated that over 60% of rural women in North India have never undergone even a basic clinical breast examination.

The Lifestyle Factor

One of the most critical influences on breast cancer risk is lifestyle. Urban women in Delhi experience higher levels of physical inactivity due to desk-bound jobs and increasing reliance on technology. According to NFHS-5 (2019–21), more than 23% of urban women in the city are overweight or obese—a significant risk factor for hormone-related cancers. Alcohol consumption and stress are also emerging threats in metropolitan areas, with studies such as The Lancet Oncology’s 2020 India report linking alcohol use to nearly 6% of breast cancer cases. Additionally, a 2023 survey by Fortis Healthcare revealed that over 70% of working women in major Indian cities, including Delhi, report high levels of stress—often overlooked in public health planning.

On the other hand, while rural lifestyles may appear physically active, they are not immune to risk. Poor nutrition, lack of reproductive health education, and delayed access to preventive care all contribute to late-stage cancer diagnosis, which significantly lowers survival rates.

Access, Awareness, and Equity

The disparity between urban and rural breast cancer outcomes highlights a critical urban-rural health inequity. While urban women benefit from screening programs, health insurance coverage, and frequent media campaigns, rural communities continue to struggle with limited infrastructure, social stigma, and misinformation. Breast self-examination (BSE), a simple and effective tool for early detection, remains poorly understood or practiced in rural areas. A 2021 study conducted by PGIMER, Chandigarh, found that fewer than 25% of rural women in North India were aware of BSE or its importance.

Moreover, despite Delhi’s status as a healthcare hub, a significant portion of its rural outskirts remains underserved. The gap in access to diagnostics and follow-up treatment further exacerbates health outcomes for women in these areas.

Toward Inclusive Solutions

Closing the gap in breast cancer awareness and care in Delhi/NCR requires a multipronged approach. Community-based screening through mobile mammography units can play a transformative role in rural areas. Public health programs must include culturally sensitive awareness campaigns that speak to women in their local languages and address social taboos directly. Simultaneously, wellness initiatives in urban areas need to prioritize stress management, dietary counseling, and regular health check-ups.

Education plays a foundational role. Integrating reproductive health and cancer awareness in school and college curricula can empower young women early in life. Strengthening the role of Accredited Social Health Activists (ASHAs) and local healthcare providers is also essential in spreading awareness and building trust within rural communities.

A Data-Driven Call to Action

Data paints a sobering picture. Nationally, one in 29 women is at risk of developing breast cancer in her lifetime. In Delhi/NCR, this risk is even more pronounced. Yet nearly 60 to 70 percent of breast cancer cases across India are detected in advanced stages, significantly reducing survival chances. In contrast, early-stage diagnosis can increase the five-year survival rate to over 90 percent, emphasizing the life-saving potential of awareness and timely intervention.

Breast cancer in Delhi/NCR is a mirror reflecting the broader challenges of India’s healthcare landscape—a landscape shaped by geography, income, education, and gender. To truly combat this disease, we must move beyond hospital-centric solutions and invest in community engagement, preventive education, and equitable access to care.

Empowering women—urban and rural alike—with knowledge, support, and timely medical attention is not just a health goal; it is a societal necessity. In doing so, we not only improve survival rates but also affirm the right to health and dignity for every woman, regardless of her postcode.

Authors Biography

Shilpi Bariar is Research Scholar at Amity Institute of Social Sciences & Dr. Roumi Deb is Professor at Amity Institute of Social Sciences Amity University Noida

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Women’s health today is moving beyond the era of one-size-fits-all checklists. For decades, screenings relied largely on age brackets or generalized guidelines, often overlooking the nuances of each woman’s unique health journey. Advances in imaging technologies and laboratory testing now allow for a far more personalized approach—catching conditions earlier, tailoring treatments, and improving outcomes significantly.

Detecting the Silent Shifts Early

Breast cancer offers one of the clearest examples of why early and precise diagnostics are crucial. With millions of new cases diagnosed globally each year, timely detection often marks the difference between conservative management and aggressive treatment. Digital mammography, especially when paired with 3D tomosynthesis, can now identify changes as small as 50 microns, dramatically improving survival rates. For women with dense breast tissue or a strong family history, combining mammography with ultrasound or MRI provides a safety net against missed diagnoses.

The same applies to other silent conditions. Pelvic ultrasound, often associated only with pregnancy, also reveals early signs of ovarian cysts, fibroids, and endometriosis—conditions that can threaten fertility or cause chronic pain if undetected. Identifying these concerns early opens up a wider range of options, from lifestyle adjustments and medications to minimally invasive procedures, before more severe interventions become necessary.

Looking Beyond Symptoms

Personalized diagnostics extends far beyond imaging. Hormonal and metabolic profiling, for instance, offers a window into underlying imbalances that may not present obvious symptoms. Comprehensive hormone panels measuring estradiol, progesterone, AMH, thyroid hormones, FSH, LH, prolactin, and cortisol can uncover early signs of PCOS, thyroid dysfunction, or adrenal imbalances years before they appear clinically. Acting proactively on these results allows preventive care, reducing long-term risks.

Bone health is another area where early diagnostics make a difference. Conditions like osteopenia and osteoporosis typically remain hidden until a fracture occurs. A DEXA scan can detect bone density loss early, especially vital for women approaching menopause or those with metabolic or thyroid-related conditions. Similarly, thyroid screenings often expose subclinical hypothyroidism—an invisible condition that quietly affects fertility, energy levels, and cardiovascular health.

Cervical cancer screening provides yet another example of the life-saving impact of diagnostics. Regular Pap smears, combined with HPV testing, detect pre-cancerous changes well before they become invasive, turning what was once a life-threatening disease into a largely preventable one.

Towards Better Outcomes

What makes personalized diagnostics transformative is not simply the array of tests available, but how they are combined and interpreted in the context of an individual woman’s risk profile. Rather than waiting for symptoms to surface, physicians are increasingly using family history, genetics, hormonal balance, and lifestyle factors to shape care pathways. This ensures higher-risk women are screened earlier and more intensively, while unnecessary testing is minimized for others.

The patient experience is also being redefined. Integrated workflows that combine imaging, pathology, and molecular testing reduce delays and uncertainty. Convenience features like home sample collection, digital reports, and online scheduling further encourage consistency in health checks—helping women prioritize their well-being without disruption.

The result is a healthcare system that identifies disease earlier, offers more precise interventions, and empowers women with clear, individualized insights. Personalized diagnostics does not replace existing guidelines; instead, it enhances them, ensuring care is both evidence-based and uniquely tailored.

Key Takeaway

Personalized diagnostics is reshaping women’s healthcare. By moving beyond generic screening models and aligning tests with each woman’s specific risk factors, it enables earlier detection, more targeted interventions, and greater preventive care. As access and awareness continue to expand, this approach offers women the ability to take charge of their health sooner, avoid complications, and build a stronger foundation for lifelong well-being.

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As per global cancer statistics GLOBOCAN 2020, breast cancer is the number one diagnosed cancer among women across the globe. For the first time in GLOBOCAN 2020, statistics show breast cancer has become the most diagnosed cancer, leaving behind lung cancer in low- and middle-income countries. As per the Indian Council of Medical Research (ICMR), the National Cancer Registry Programme Report 2020 incidence of breast cancer is 2 lakh (14.8%) of the total cancer burden. Further evidence of changing lifestyles due to urbanization and its influence on the incidence of breast cancer is increasing. Consequently, changing lifestyle factors are essential to consider when developing a strategy for breast cancer prevention and reducing the global burden of disease. In recent years, there has been a notable increase in the incidence of breast cancer, coinciding with profound changes in the lifestyle of women in this urban setting.  India, amidst rapid urbanization, stands at the crossroads of progress and public health challenges. As cities burgeon and lifestyles evolve, the specter of breast cancer looms larger, casting a shadow over the health landscape of urban women. Delving into statistical evidence provides crucial insights into the complex interplay between urbanization and the escalating incidence of breast cancer among Indian women. By examining the statistical trends and referencing pertinent studies, we can unravel the multifaceted relationship between changing lifestyles due to urbanization and the burgeoning breast cancer burden in India.

Statistical Trends in India: Statistical data underscores the alarming rise in breast cancer incidence across urban cities in India. According to the Indian Council of Medical Research (ICMR), breast cancer has surpassed cervical cancer to become the leading cancer among Indian women, with urban areas bearing a disproportionate burden. Studies have revealed a significant urban-rural divide, with urban regions reporting higher breast cancer incidence rates compared to rural counterparts. For instance, a study published in the Indian Journal of Medical Research found that metropolitan areas exhibited a 1.5 to 2-fold higher incidence of breast cancer than rural areas, highlighting the profound impact of urbanization on disease prevalence.

Sedentary Lifestyles and Obesity: Urbanization catalyzes the proliferation of sedentary lifestyles characterized by desk-bound occupations, dependence on motorized transport, and reduced physical activity opportunities. Coupled with the influx of changed dietary patterns dominated by processed foods and high-calorie diets, urban communities are increasingly predisposed to obesity and metabolic syndromes, potent risk factors for breast cancer. Statistical studies corroborate this association, with studies such as the India State-Level Disease Burden Initiative reporting a rising prevalence of obesity among urban women, particularly in metropolitan areas like Delhi and Mumbai. The confluence of sedentary behaviours and dietary shifts emphasizes the breast cancer risk landscape, necessitating targeted interventions to promote physical activity and healthy eating habits among urban populations.

Reproductive Trends: The urban milieu engenders transformative shifts in reproductive behaviors, with delayed childbearing, declining fertility rates, and reduced parity becoming more commonplace among Indian women. Studies have elucidated a positive correlation between delayed childbirth and increased breast cancer risk, attributing this association to prolonged exposure to endogenous estrogen and reduced duration of breastfeeding. The National Family Health Survey (NFHS) data corroborates these findings, revealing a declining trend in fertility rates and breastfeeding practices among urban women in India. Addressing the implications of altered reproductive patterns on breast cancer incidence necessitates comprehensive reproductive health education and family planning initiatives tailored to urban contexts.

Environmental Exposures: Urban environments in India are fraught with myriad environmental pollutants and carcinogens, ranging from vehicular emissions and industrial effluents to indoor air contaminants and pesticide residues. Studies have highlighted the role of environmental exposures in fuelling the breast cancer epidemic among urban women, with urban residents facing heightened risks due to chronic exposure to airborne pollutants and endocrine-disrupting chemicals. Research published in Environmental Health Perspectives has identified urban air pollution as a significant risk factor for breast cancer, emphasizing the urgent need for stringent regulatory measures and pollution control strategies to safeguard women’s health in urban India.

Conclusion: As India undergoes rapid urbanization, the escalating burden of breast cancer among urban women demands urgent attention and concerted action. By leveraging statistical evidence and referencing pertinent studies, we can elucidate the intricate nexus between changing lifestyles due to urbanization and the burgeoning breast cancer epidemic in India. Empowering women with knowledge, promoting healthy lifestyle choices, enhancing reproductive health awareness, and advocating for environmental stewardship are imperative to mitigate the adverse impact of urbanization on breast cancer incidence and foster a future of health equity for all women in India.

Authors Biography

Shilpi Bariar has worked as science administrator in University scientific Administration.Presently she is working as Grant Manager in School of Natural Sciences Shiv Nadar Institute of Eminence Delhi/NCR. 

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International Women’s Day 2024 carries the powerful theme of “Inspire Inclusion,” emphasising the overarching call to action to “Invest in Women: Accelerate Progress.” This theme underscores the significance of creating an inclusive society and empowering women. Amidst the celebrations, it is crucial to direct our attention to an often-neglected aspect—women’s health. As we delve into the importance of health for women, we unveil the challenges they face and the imperative for healthcare professionals to take the lead in fostering awareness and change.

The Health Imperative:

The famous Arabian proverb “He who has health has hope, and he who has hope has everything” resonates profoundly on International Women’s Day. Health is a fundamental aspect that transcends age, gender, and socioeconomic standards. Regrettably, despite its paramount importance, the health of women often takes a backseat in priorities.

Women and Health Disparities:

Studies consistently reveal that women encounter more health issues than men. The World Health Organization (WHO) highlights that in regions grappling with economic, societal, and cultural inequalities, women are more susceptible to significant health challenges. These issues not only impact their quality of life but also perpetuate a cycle of poverty and disease for women and their families.

The Role of Nurses:

Nurses, as frontline healthcare professionals, play a pivotal role in improving women’s health. By providing education, healthcare services, and raising awareness of key issues, they can contribute significantly to breaking the cycle of health disparities. It is essential for healthcare professionals to not only address existing health issues but also identify and address the root causes in the local healthcare practices.

Focus Areas in Women’s Health:

Maternal and newborn morbidity and mortality, reproductive health issues, sexually transmitted diseases, gender discrimination, lack of education, violence toward women, reproductive cancers, and restricted access to healthcare are among the common issues ailing women’s health. The prevention of reproductive cancers, particularly cervical cancer, emerges as a critical focus area due to its preventable nature.

Non-Communicable Diseases (NCDs):

Non-communicable diseases (NCDs) pose a significant threat to women’s health, especially in low- and middle-income countries. Cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes contribute to a staggering number of premature deaths. Lifestyle factors such as tobacco use, physical inactivity, unhealthy diets, and alcohol consumption significantly contribute to NCDs, making them modifiable risk factors.

Authors Biography

Dr. Raminder Kalra Ph.D. in Nursing from IGNOU, with 38+ years of experience, serves as the Principal at Holy Family College of Nursing. Recognized with prestigious accolades like the President’s Gold Medal and RULA Ratna Research Award 2019. She is a distinguished examiner for nursing examinations across multiple universities. Dr. Kalra has authored papers in renowned journals and contributed to the book “Postgraduate Psychiatry.”

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When it comes to menstruation, there is still a lot of stigma attached to it. In certain cultures, menstruation is considered filthy and disgusting. This creates a hush-hush atmosphere surrounding it, which should not be the case. It is a physiological function, just like any other, that is essential for reproduction. A stigmatised air around menstruation inhibits adolescent menstruators from receiving genuine, solid knowledge about what is going on with them. It is either forbidden, sacred, or invalidated. Where is the true picture?

Let’s go all the way back to ancient civilizations for the first known mentions of menstruation. Pliny the Elder, a Roman philosopher, was persuaded that periods were some kind of mystical trickery back in the day. He said that women on their periods could destroy large fields of crops, drive bees from their hives, and manipulate the weather. Regrettably, attitudes concerning menstruation were not much better during the Middle Ages. People went to tremendous lengths to conceal their periods due to religious embarrassment, and some even claimed cramps were a heavenly punishment for Eve’s initial sin. Those who were menstruating were not administered pain relief medication because cramps were viewed as a punishment (mostly herbal remedies at the time).

People in mediaeval times would either use rags to absorb their menstrual blood (ever wonder where the phrase “on the rag” comes from?) or they would free bleed. Periods entered the Bridgerton era in the late nineteenth century, and the first menstrual products were invented. People wore sanitary belts from the 1890s until the early 1980s, which were simply reusable pads tied to a belt worn around the waist – and yes, they were as terrible as they sound. Brands began to release adhesive disposable pads in the 1970s, comparable to what we see now in the menstruation goods aisle. Initially, adhesive pads were heavy and uncomfortable to wear, but they were an improvement over having to suspend your pad from a string.

Biologically, the menstrual cycle is characterized by regular and recreating hormonal changes, including changes in the ovarian hormones estrogen and progesterone. The cycle is divided into two distinct phases the follicular phase, which lasts from period to ovulation and varies in length, but generally lasts 14 days; and the luteal phase, which is the alternate half of the cycle after ovulation and leading up to period and lasts constantly for 14 days. The days before the period are generally termed as the premenstrual phase. During period, estrogen and progesterone situations are fairly low.

As the cycle progresses through the follicular phase, estrogen situations rise, egging the pituitary gland to produce a swell of follicle- stimulating hormone and luteinizing hormone which helps eggs develop in the ovaries. Once the most advanced egg is discharged, the follicle transforms into a corpus luteum that generates steadily adding situations of progesterone as well as a small quantum of estrogen. However, progesterone and estrogen situations drop, the filling of the uterus breaks down, If the egg isn’t fertilized. further than half of menstruating women report some pain during their period, with some estimates as high as 84.

Another study set up that 32- 40 of people who have their period report that the pain is so bad that they’ve to leave work or academy. still, it’s not just the physical signs of period that can beget discomfort and anxiety. Hormonal oscillations during periods can have a direct effect on your mood, with some people suffering from premenstrual dysphoric complaints (PMDD). PMDD affects about 5- 8 of women worldwide and is a severe type of premenstrual pattern that causes both cerebral and physical symptoms. utmost menstruating women witness some symptoms of premenstrual pattern( PMS), similar as mood swings and headaches, despair, wrathfulness, pressure and solicitude.

The symptoms of PMDD, which are intricately linked to your current internal health, are analogous to those of major depression. This means that women suffering from PMDD face the same troubles as women suffering from major depression, similar to an increased threat of self-murder during the two weeks they’re affected. The inverse effect is also true. Mental health problems in general can beget or worsen menstrual problems. According to exploration, women who have an anxiety or substance use complaint had shorter ages.

Creativity helps us process our feelings more by furnishing an outlet for all our sentiments, whether positive or negative. hear to music- It’s true that music has been proven to promote internal well- being, reduce stress, and reduce the product of cortisol( the stress hormone) in our brain.

According to one study, there’s a” significant relationship between stress and the circumstance of dysmenorrhea,” or uncomfortable period that generally manifests as cramps. It set up that those who were under a lot of stress were doubly as likely to get dysmenorrhea also, studies have set up a correlation between those who work in stressful surroundings having shorter menstrual ages. A normal cycle lasts around 28 days, and anything lower than 24 days is considered short.

Here are some suggestions for taking care of your mental health throughout your cycle :

Try Exercise – Research shows that regular aerobic exercise can help reduce and improve PMS symptoms such as sadness and exhaustion.” It’s natural to be afraid to exercise this time of the month. Exercise, on the other hand, causes the release of a chemical known as endorphins. They interact with pain receptors in the brain, they reduce the perception of pain and induce good emotions in the body. As a result, moderate exercise can help ease the cramps and discomfort associated with PMS. Serotonin and dopamine are two chemicals released during exercise that not only improve your mood, but can also suppress anxiety-inducing hormones. One study found that three sessions of 60-minute exercise each week for eight weeks significantly reduced PMS symptoms in women. Exercise can even help manage bloating and water retention. “Remember to do what feels comfortable, and don’t overdo it.”

Stress Management Practices – As a result, stress management practices should be used throughout the menstrual cycle. PMS can be stressful enough on its own, especially when the symptoms disrupt your daily routine, such as cramps that make it difficult to get out of bed or mood swings that disrupt relationships. When you are stressed, your body produces increased amounts of cortisol and corticotropin-releasing hormone (CRH). They are also referred to as stress hormones. When stress has a particularly strong effect on your hormones, it can result in missed or late periods. Stress is a major cause of uncomfortable menstrual symptoms because it disrupts your hormones and can disrupt your cycle.

Get enough sleep – when you are stressed, sleep can help you cope. Sleep improves your mental health and helps treat anxiety and sadness. During your period, try to get six to eight hours of sleep each night. If you can’t do this consistently, aim for at least six hours of sleep each night. You can also try taking naps during the day if that works better for your schedule than going to bed early at night. It also improves your mood and minimizes the harmful effects of PMS (premenstrual syndrome) hormones.

Healthy Diet – A nutritious diet has been shown to increase mental well-being. In fact, one study found that following a Mediterranean diet was associated with lower rates of sadness and anxiety. In fact, studies have shown that eating a nutritious diet can help reduce symptoms of depression by up to 50%. For starters, consider increasing your intake of omega-3 fatty acids, found in fish like salmon and trout, as well as flaxseed oil. They help fight inflammation in the body, which can contribute to physical and mental health problems like depression. Omega-3 fatty acids also increase serotonin levels, which improves mood! Increasing your intake of vitamins B6 and B12 will also help improve your mental well-being. These vitamins are needed for the production of neurotransmitters such as norepinephrine, which affects how quickly signals are transmitted between brain cells, or neurons. In other words, they help keep everything in order.

Do yoga – According to healthcare experts, rehearsing yoga during your period can help ameliorate your emotional state and overall health. Yoga can help you fight internal problems and sleep better. Yoga is a great approach to reducing stress, which can be particularly dangerous for those suffering from hormonal problems similar to PMS or menopause. Yoga can also help you feel more and help acne flare- ups during your period. Yoga is also an excellent tool for managing stress and other negative feelings, as well as perfecting your station and outlook on life. rehearsing yoga allows you to concentrate on the present moment rather than getting caught up in unwelcome studies or passions. 

Get creative- Being creative during your menstrual cycle can help you ameliorate your internal health. The stylish thing about being creative is that it does not have to be a commodity big or fancy and you can do it whenever and wherever you want. Indeed if you are not feeling well, you can buck up your days by creating a picture or composing a lyric. There are several ways creativity can profit your internal health.

Creativity helps us process our feelings more by furnishing an outlet for all our sentiments, whether positive or negative. hear to music- It’s true that music has been proven to promote internal well- being, reduce stress, and reduce the product of cortisol( the stress hormone) in our brain. That is because music is a form of tone- expression that helps us connect with others in ways that words alone do not always allow. Health professionals have actually recommended that people suffering from depression listen to music during their menstrual cycle because it helps them feel more emotionally. 

Quit smoking and limit alcohol input – Tobacco use is dangerous to health. It has a significant effect on internal and physical health. Women are affected more than men by smoking during this period. Women are more prone to pinging a cigarette due to hormonal changes in the body during this period. Cigarette bank disrupts a woman’s menstrual cycle, performing in irregular ages, heavy bleeding and an increased threat of gravidity. Drinking alcohol during your period isn’t a good idea. It can beget a number of unwanted side goods, including headaches, nausea and vomiting, dizziness, prostration and stomach derangement. In addition to these physical goods, drinking alcohol during your period affects your internal health.

Menstruating women can suffer from a range of unwelcome symptoms during their’ period’, from minor discomfort, lower aft pain, prostration and bloating to severe pain, heavy inflow and cramping. They can occasionally intrude with an existent’s diurnal conditioning. Some people may not be suitable to go to work or academy because of discomfort that prevents them from performing typically. The effect of period on internal health highlights the significance of hormones in the brain- body connection and how they affect moods and therefore studies.

Knowing the patterns of these changes in our brain and body can help one understand their problem and learn about our studies, inspiring us to take care of ourselves in new and salutary ways. Realizing the significance of women’s internal health is the first step to perfecting internal health during ages. Second, we need to address this issue by encouraging women and girls to talk about and learn about their bodies. 

Last but not least, we should raise awareness of women’s internal health with the support of family members, preceptors and musketeers, among others. These conduct should help ameliorate our internal health during the period.

“Composed by: Dr.Tanya Gujral is Physiotherapy Professional. She has Published more than 10 articles in reputable Journal and also reviewer in national and international journal and also have 2 book chapters.”

“Mr. Lakshay Attri, is pursuing Bachelor of Physiotherapy. Lakshay is determined to acquire new physiotherapy skills and make a positive impact on people’s lives.”

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