We all recognise the significance a timely or early cancer diagnosis can have, but there are so many confounding factors that often influence the possibility of this. Sometimes day-to-day life gets in the way of us prioritising a regular health check-up or a cancer may initially and unfortunately be asymptomatic. As a leading cause of premature death in every country in the world, and with the burden of cancer expected to spiral in the coming decades, it is more vital than ever that we raise awareness of the importance of early diagnosis, where possible, to advance health outcomes.

A new report, Supporting Women With Cancer, spotlights the opportunities and barriers we must overcome to improve early detection. According to the report, education about cancer in women is not where it needs to be. In a survey that Merck conducted among 4,585 women with cancer, only 45% of respondents said they were aware of cancer signs and symptoms before receiving their diagnosis. Awareness of common cancer risk factors such as tobacco use is well-known, but society is only now recognising that other factors such as obesity, alcohol consumption and physical inactivity can increase a person’s chance of developing the disease.

In October, the American Cancer Society, Union for International Cancer Control and International Agency for Research on Cancer released The Cancer Atlas. It emphasised that ‘potentially modifiable risk factors’ like those noted above cause almost half of cancer deaths globally. It is clear a greater focus is needed to improve women’s understanding and recognition of the signs, symptoms and risk factors of cancer to reduce this.

Another interesting insight the Supporting Women With Cancer report showed was that cancers that are not widely considered ‘women’s cancers’ are being overlooked. According to the World Health Organisation, as of 2018, the cancers with the highest mortality in women are breast, lung and colorectal cancer. The women surveyed however perceived the cancers with the highest mortality to be breast (73%), cervical (41%) and ovarian (34%). While this may show the effectiveness of female cancer advocacy and education, which continues to be of crucial importance, it also suggests more can be done to improve education around other types of cancer, not just those typically linked to women.

Although we know understanding the risks is important, awareness of and access to health interventions that promote early detection are also critical. Screening is an essential part of improving early diagnosis as it can identify individuals who have cancer but may not yet have symptoms. Further data from the survey highlighted that awareness of, and access to, available cancer screening programmes must be improved. Nearly 50% of women surveyed had never attended a cancer screening programme. For women aged 18-59, the most common reason cited was that they did not think they needed to attend. Women aged 18-40 were also more likely to face delays in diagnosis (49%) compared to other age groups, mainly due to not taking their symptoms seriously (43%). To remove barriers to accessing screening programmes, it is vital that women understand the benefits of early cancer detection.

Regardless of a woman’s age, location or socio-economic background, she should have access to the support services and information needed to make informed decisions about her health to increase her chance of survival. Our survey data indicate that women with lower levels of formal education were less likely to access a screening programme, irrespective of a country’s economy (as measured by Gross Domestic Product). This indicates that we need to consider how to reach different women across society, ensuring that public health campaigns resonate with women across all levels of formal education.

Screening programmes will differ across countries and even within countries across regions, but what must underpin all efforts is the common approach to reducing any barriers that may prevent women from accessing information regarding these programmes, and ultimately attending. Uptake of programmes should be continuously monitored, evaluated and assessed. It will take all of us, patients, governments, healthcare professionals, employers, academics and other stakeholders, to determine how we can work better together as a community, to increase uptake, and wherever possible, support earlier diagnosis of cancer in women.

About Supporting Women With Cancer  
The Supporting Women With Cancer report is based on a survey, supported by Merck KGaA, Darmstadt, Germany and designed with input from the Union for International Cancer Control (UICC), of 4,585 women in 23 countries. The research aimed to understand the unique challenges that women with cancer face across the globe and supports the Healthy Women, Healthy Economies global initiative that brings together governments, the private sector and other stakeholders such as non-governmental organisations (NGOs) and patient groups to address women’s health so women — and by extension their families — can live better lives. For more information, read the full report and its recommendations here.

Maria Rivas is chief medical officer and SVP of Global Medical Affairs and Global Evidence and Value Development at Merck KGaA