41.9% to 87.3%: WHO breast cancer survival study reveals stark gap between rich and poor nations

Five-year breast cancer survival varies dramatically by national income level, according to the World Health Organization’s first country-wise survival estimates, published in Nature Medicine. Median five-year survival stood at 87.3% in high-income countries, compared with 78.7% in upper-middle-income countries, 60.1% in lower-middle-income countries and just 41.9% in low-income countries.

The study, covering all 194 WHO member states, found India’s estimated five-year breast cancer survival rate for women diagnosed during 2017-2021 at 65.7%, against a global median of 77.8%. Survival reaches 88.5% in the WHO region of the Americas and 84% in the European region.

Breast cancer is now the most common cancer among women in 158 countries and caused an estimated 6.9 lakh deaths globally in 2024, with nearly 70% of those deaths occurring in low- and middle-income countries. The WHO said survival depends largely on early diagnosis and timely access to surgery, radiotherapy and cancer medicines, with stage at diagnosis remaining one of the strongest predictors of outcomes.

The estimates give countries a baseline to track progress under the WHO Global Breast Cancer Initiative, which aims to reduce premature breast cancer mortality by 2.5% every year and save 2.5 million lives by 2040. They were derived using survival data from cancer registries in 67 countries, with statistical modelling applied for countries lacking complete registry data.

In India, survival has steadily improved, though only about two of three women diagnosed with the disease survive at least five years. Abhishek Shankar, assistant professor of radiation oncology at AIIMS, said gains from community-based screening and Ayushman Bharat-PMJAY are offset by many women presenting with advanced disease due to low awareness, stigma, financial barriers and delays in diagnosis.

Shankar added that disparities in access to pathology, imaging, radiotherapy, systemic therapy and follow-up care, particularly between urban and rural areas, continue to affect outcomes, and that strengthening early detection and equitable access to treatment is essential to closing the gap.