The Global Impact of Breast Cancer

On Monday, January 26, 2015, Dr. Julie Gralow, Director of Breast Medical Oncology at the University of Washington and Dr. Ophira Ginsburg, a medical oncologist at the University of Toronto will join us to talk about breast cancer’s global impact.


– Nearly 2 million women are diagnosed with breast and cervical cancer every year.
– Breast cancer is the leading cause of cancer-related mortality in women worldwide.
– In many countries breast and cervical cancer are shameful conditions and women are afraid to seek medical attention for their symptoms until it is too late.
– Over 70% of all cancer deaths occur in low- and middle-income countries (LMICs); cancer has surpassed infectious disease as the leading cause of death in many LMICs.
– Over half of new breast cancer diagnoses and 62% of breast cancer deaths occur in LMICs, yet only 5% of global spending on cancer is spent in these regions


Worldwide, the annual number of new breast cancer cases more than doubled over the past three decades from 641,000 in 1980 to 1.67 million new breast cancer cases in 2012.[i] Breast cancer is the most prevalent cancer in woman worldwide; however, more than half of new breast cancer diagnoses and 62% of cancer deaths occur in low- and middle-income countries (LMIC).[ii] While incidence rates are much higher in North America (91/100,000) compared to Latin America (47/100,000) Sub-Saharan Africa (33/100,000) and Central and Eastern Europe (47/100,000) mortality rates are similar at 14/100,000 in North America, 13/100,000 in Latin America, 17/100,000 in sub-Saharan Africa and 16/100,000 in Eastern Europe. Despite lower incidence rates in LMICs, case fatality rates are significantly higher. Global cancer projections estimate that by 2025, 80% of the increase in the number of all cancer deaths will occur in LMIC.[iii]

Higher rates of breast cancer mortality in low-resource settings have been attributed to a lack of awareness regarding the benefits of detection and treatment, late stage diagnosis and limited access to care.[iv] Over the past 60 years breast cancer outcomes in the United States have improved remarkably and have been attributed to advances in early detection and treatment; however, the case fatality rate in the US decreased even before the generalized introduction of mammography and adjuvant therapy, suggesting that improvements in cancer outcomes can be made in LMIC even where mammography and adjuvant therapy are not available. More specifically, analysis of breast cancer data prior to 1974 attribute the improved outcomes to increased breast cancer awareness, effective education and detection of palpable tumors and improved diagnostics. Advocacy and awareness-building are an integral step in curbing the emerging trend of breast cancer as a significant health threat to women worldwide. The breast cancer advocacy movement in North America and Western Europe has proven to be a powerful force for the advancement of cancer control. In most LMICs, where cancer is generally a lower priority, cancer advocacy is growing, but remains less developed.


WE CAN aims to make real and lasting change toward reducing breast and cervical cancer-related death and morbidity by arming cancer advocates with information about cancer, linking them with other advocates and offering advocacy training to enable the success of their efforts. Through our summits we build networks and connect advocates, physicians, survivors, patients and policy makers. We believe the power of individual survivor advocates is multiplied through supporting regional networks to facilitate the exchange of best practices, build capacity, influence public policy and social norm change and empower women leaders. WE CAN advocacy training fosters capacity building, knowledge transfer and sharing of best practices in advocacy and outreach to dispel damaging myths and misconceptions about cancer, reduce stigma and improve survivorship.

Headquartered at the UW School of Medicine and the Seattle Cancer Care Alliance, WE CAN has been a global network for change since 2003. Through partnerships with the National Cancer Institute Center for Global Health, Susan G. Komen for the Cure, the Resource and Policy Exchange and local hosts and supporters, WE CAN has organized 9 summits in Eastern Europe and Central Asia, East Africa and Latin America connecting more than 500 women from over 25 countries and resulting in regional networking, new initiatives and collaborations and increased awareness.

1/26/15 Tweet Chat Transcript


Globobcan 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012
The Cancer Atlas from American Cancer Society
Union for International Cancer Control
WHO Global Cancer Country Profiles
US NCI Center for Global Health
Women’s Empowerment Cancer Advocacy Network (WE CAN)
Global Focus on Cancer
Susan G. Komen for the Cure Global Initiative for Breast Cancer Awareness
LiveSTRONG Anti-Stigma Campaigns
Pink Ribbon Red Ribbon
 Breast Health Global Initiative
Global Task Force for Expanded Access to Cancer Care and Control
Closing the Cancer Divide


[i] Mohammad H Forouzanfar, Kyle J Foreman, Allyne M Delossantos, Rafael Lozano, Alan D Lopez, Christopher J L Murray, Mohsen Naghavi. Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis. The Lancet. 2011 Oct 22; 378(9801):1461-84.

[ii] Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F.
GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet].

[iii] World Cancer Report 2014. IARC. Available at: http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=76&codcch=31

[iv] Lawrence N. Shulman, Walter Willett, Amy Sievers, and Felicia M. Knaul, “Breast Cancer in Developing Countries: Opportunities for Improved Survival,” Journal of Oncology, vol. 2010, Article ID 595167, 6 pages, 2010. doi:10.1155/2010/595167


Dr. Julie Gralow

Dr. Julie Gralow

Dr. Julie Gralow is the Jill Bennett Endowed Professor of Breast Cancer and Director of Breast Medical Oncology at the University of Washington (UW)/Seattle Cancer Care Alliance, as well a Member of the Clinical Research Division of the Fred Hutchinson Cancer Research Center (FHCRC), an adjunct professor in the Department of Global Health and a faculty member in the Ellison Center for Russian, Eastern Europe and Central Asian Studies in the Jackson School of International Studies at UW. Dr. Gralow is the founder of the Women’s Empowerment Cancer Advocacy Network (WE CAN) which had been supporting cancer advocacy and education in low and middle income countries in Eastern Europe and Central Asia and East Africa for over a decade, and co-secretariat for the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries. She received her bachelors degree from Stanford University and MD from the University of Southern California. She completed her residency in internal medicine at Brigham and Women’s Hospital at Harvard Medical School and a medical oncology fellowship at Fred Hutchinson Cancer Research Center.

Dr. Ophira Ginsburg

Dr. Ophira Ginsburg

Dr. Ophira Ginsburg is a medical oncologist with expertise in cancer genetics, epidemiology, prevention and screening. Her research focus is on global cancer control and women’s health equity. She is a Scientist at Women’s College Research Institute; Assistant Professor in the Faculty of Medicine and the School of Public Health at the University of Toronto; an Adjunct Professor at the James P Grant School of Public Health, BRAC University, Dhaka Bangladesh; an Advisor to the National Cancer Hospital and National Institute for Cancer Control of Vietnam, and a member of the academic faculty at the Institute of Cancer Policy, King’s Health Partners, London. Since 2004, Dr. Ginsburg has developed a program of population intervention research in global cancer control. She is principle investigator on studies of population differences in breast cancer risk factors and outcomes, as well as inequities in access and utilization of breast cancer services among marginalized women in Asia, and among immigrants and ethno-cultural minority women in Canada.