Every year, millions of women are affected by breast cancer. For expatriates, being far from their home country can complicateaccess to appropriate screening and care. Understanding global differences can save lives.
Breast cancer is the most common cancer in women, affecting around 2.3 million women worldwide each year, with 670,000 deaths expected by 2022. But beyond the numbers, it’s a reality that varies considerably between countries, healthcare systems and cultural contexts. For expatriates, understanding these differences is essential to ensure optimal follow-up, even far from home.
Worldwide disparities in incidence and mortality
Breast cancer incidence rates vary widely from country to country. For example:
- France: 65,659 new cases (standardized rate: 105.4/100,000)
- United States: 274,375 new cases (standardized rate: 95.9/100,000)
- China: 357,161 new cases (standardized rate: 33.0/100,000)
These differences are due to factors such as access to care, eating habits, family history and screening behaviors.
Screening: an uneven public health challenge
Breast cancer screening is a key tool for reducing mortality. European countries, for example, offer organized national screening programs, often based on mammography every two years for women aged 50 to 74. By contrast, in some low- and middle-income countries, screening is limited or non-existent, often resulting in diagnosis at a more advanced stage.
A WHO study showed that by 2021, countries with regular screening programs had about 3.74 fewer deaths per 100,000 women than those with irregular programs.
Screening programs
High-income countries generally have organized screening programs:
- Europe: most countries offer mammography programs every two years for women aged 50 to 74.
- United States: recommendations vary, but screening often begins at age 40.
On the other hand, in many low- and middle-income countries, screening programs are either non-existent or limited to certain regions, resulting in diagnoses that are often at a more advanced stage.
Treatment
Treatment options also vary:
- Developed countries: access to a full range of treatments, including surgery, radiotherapy, chemotherapy, hormone therapy and targeted therapies
- Developing countries: limited access to advanced treatments, with increased dependence on surgery and chemotherapy.
Living with breast cancer as an expatriate
Being an expatriate can complicate access to breast cancer care. Challenges include:
- Language and cultural barriers: difficulty understanding local healthcare systems and communicating with healthcare professionals.
- Limited access to healthcare: particularly in countries where expatriate women are not covered by national health systems.
- Social isolation: estrangement from family and friends, which can affect emotional support.
However, innovative initiatives are emerging. In India, for example, the “Jiboner Sathi” program trains breast cancer survivors to support other patients throughout their treatment. This model has been hailed by the medical journal The Lancet.
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Inspiring initiatives
India: the “Pink Corridor” model
In India, the “Pink Corridor” initiative aims to raise awareness and provide screening services in rural areas. In one year, nearly 59,000 women were screened, with 1,900 confirmed cases of breast cancer. The program uses local health centers, community workers and telemedicine to overcome geographical and social barriers.
United Kingdom: revolutionary blood test
The British NHS has launched a blood test capable of detecting cancer up to a year before it appears on traditional scans. The test, based on circulating tumor DNA, offers a non-invasive method of detecting cancer at an early stage, improving the chances of effective treatment .
Practical advice for expatriate women
Find out about local resources: First and foremost, find out about screening centers, specialized hospitals and cancer associations in your host country. Many countries organize annual awareness campaigns in October, such as the famous “Pink October”, where you can take part in local events and access useful information.
Create an international medical file: Gather all your medical history, mammogram results and previous treatments. This comprehensive file will facilitate continuity of care, especially if you need to consult different doctors or change countries.
Take advantage of healthcare technologies: teleconsultations, medical applications and online monitoring services can greatly simplify your remote medical monitoring, enabling you to stay in touch with your doctors and manage your appointments or treatments even when you’re far from your home country.
Get involved in awareness campaigns: Participating in local or online initiatives helps support breast cancer research and education. It’s also a great way to network with other patients and strengthen your support network.
Health insurance and coverage for expatriates
For expatriates, having the right health insurance is crucial, especially in the case of breast cancer. Coverage varies widely between countries and insurance companies: some offer full cover for consultations, examinations, treatment and hospitalization, while others limit reimbursements or exclude certain advanced therapies. Check your insurance before you leave or as soon as you arrive in a new country. Make sure it covers screening, surgery, chemotherapy, hormone therapy and targeted treatments. Compiling a detailed medical file and knowing the local reimbursement procedures will ensure continuous follow-up and avoid interruptions in care, which are essential for effective treatment.
Cancer abroad for expatriates
Breast cancer is a worldwide reality, but the means of fighting it vary from country to country. As an expatriate, it’s crucial to be informed and prepared, and to surround yourself with the necessary resources to ensure quality follow-up. Breast Cancer Awareness Month is a reminder that, everywhere in the world, prevention, screening and support are essential to saving lives.
