This is especially concerning in Asia, where rates of illness are expected to rise in the coming years. When it comes to breast cancer, for instance, Asia currently accounts for 45% of all global breast cancer cases, but cases are projected to rise by a further 21% between 2020 and 2030, with related mortality projected to increase by 27.8%. Even more shocking is the fact that breast cancer is striking Asian women at a younger age than their Western counterparts, peaking at 40-50 years versus 60-70, meaning that many women are impacted in the prime of their lives.

With breast and cervical cancer rates predicted to rise, we must ask ourselves: Why is it that cancers that can be screened for, and are often manageable if caught early, are being diagnosed only once they have progressed significantly? The delay in diagnosis can be largely attributed to gaps in public healthcare systems that are adversely impacting a staggering number of cancer patients.

Public or government funded healthcare services play a key role in providing access to care for a diverse range of patients, offering an alternative to the higher costs typically associated with private practices. However, according to the Roche Enhancing Healthcare Equity for Women in Asia Pacific Survey, only 16% of women in the eight countries surveyed said that their healthcare system is fair and equitable in its treatment of women. And although half of these women mentioned that they can easily access cervical cancer screening, only 22% feel very knowledgeable about cervical cancer, implying a potential knowledge gap in approximately 250 million women in Asia Pacific when it comes to one of the most preventable cancers. We see similar trends in other areas of women’s health, such as breast cancer.

This signals a clear need for women in Asia to have access to integrated healthcare systems that provide women-centric care. This means offering services closer to home to reduce time away from their lives and families, better education about the diseases that are most likely to impact them or their loved ones and ensuring that related screening and treatment are readily available when they seek them. To make this a reality, policymakers must prioritize public health initiatives and craft policies to address gaps in women’s cancer care in Asia, including gaps in public healthcare systems and health education. Collaboration with different stakeholders, such as healthcare companies, medical staff, and patient advocacy groups, will be crucial as we seek to address these gaps in ways that prioritise the women living with these illnesses.

Women’s cancer care must be prioritized in national health plans

One such collaboration is the APAC Women’s Cancer Coalition. Formed in 2023, the Coalition, which was founded by Roche and partners from TogetHER for Health, CAPED and Jhpiego, focuses on identifying opportunities and addressing the gaps to support countries in achieving their national targets for cancer prevention and control. An Economist Impact report commissioned by the APAC WCC, “Impact and opportunity: the case for investing in women’s cancers in Asia Pacific,” examined the challenges faced by breast and cervical cancer patients in six countries in APAC, namely India, Indonesia, Malaysia, the Philippines, Thailand and Vietnam and identified some immediate steps that countries can take to ensure equitable access to cancer treatment. These included the need for governments to have clear national cancer elimination plans in place and align their strategies with the World Health Organization (WHO) targets for breast and cervical cancer. Additionally, governments must focus on prevention through national immunization programs and organized population-based national screening programs and make women’s cancers a priority in national health plans and agendas.

Almost as important as the implementation of these programs, is putting in place a way of understanding how successful they are amongst the target communities, so we must also see a move towards improving performance tracking by building immunization registries, screening, and patient outcome registries. If this is done effectively, then we can truly understand the real-life impact of these critical programs and make necessary adjustments based on the data collected to ensure they reach the people who need them most.  

One important call out is that governments and other stakeholders need to set realistic targets for each program that take into account the unique challenges faced by each region and population group, so that the outcomes and impacts can be understood within that context. For instance, patients in rural areas will not have the same access to health facilities as those living in cities and might not, in some regions, have any medical facilities at all. Before launching programs to address access to medical care, policymakers need to take stock of resource allocation and potential capacity issues, such as resourcing to accommodate extra patients, funding, and appropriate staffing support.

Finally, governments must also focus on devising efficient and sustainable funding solutions to truly meet patients’ needs well into the future. Referral and treatment pathways for patients should also be clear and well-defined so that they are encouraged and empowered to navigate the healthcare system on their own.

Private-public partnerships are equally important in addressing gaps in access

Given the number of different factors at play that affect equitable access to healthcare, collaboration across sectors is needed to drive meaningful impact. It is only when we can leverage insights generated by governments, the private sector, on-the-ground NGOs, and community leaders that we can address the breadth of issues here and develop comprehensive strategies that can move the needle for women’s cancer care.

For instance, out-of-pocket (OOP) payments – significant in the APAC region – pose a great burden to patients and their families. For patients from lower socio-economic backgrounds, treatment costs can be catastrophic. Patients end up delaying medical care because of the added cost and are oftentimes unaware of the consequences of doing so.

So, it is important that low-cost options are prioritised when looking at low-income patients living in countries where national budgets are already constrained. For example, telehealth options that cover doctor visits and collaborative video tele-mentoring models for medical education and care management can connect national centres of excellence to remote and underserved areas. By training and mentoring healthcare personnel in these communities, they are enabled to diagnose and treat patients faster and more effectively, providing better care to more people, where they live. 

But there are other cultural and societal reasons for women not seeking diagnosis or treatment. We know that many women delay or avoid treatment due to family obligations, like caring for children and older relatives or taking care of household tasks. In some communities, cultural norms might also prevent patients from taking screening tests. For instance, illnesses like cervical cancer are often tied to cultural taboos surrounding sexually transmitted diseases (STDs) and at-risk patients might not wish to visit a doctor or clinic. Even if they are aware that they should, the shame or fear that is associated with the visit is enough of a deterrent for them to continue to delay treatment.

Here is where national and community-led organizations can prove invaluable collaborators for those looking to create change and get more patients into doctors’ offices. Patient advocacy groups and other community support networks have been instrumental in driving public health awareness campaigns, distributing educational learning materials and creating safe spaces for discussions and support networks. These groups are also not only aware of the cultural nuances at play but can also offer first-hand insights and data to back up solutions to the issue. We can then distil this information to fully understand where the issues in that community lie and co create solutions that will help resolve those issues.

For example, Roche recently launched an initiative alongside ROSE (Removing Obstacles to cervical ScrEening) Foundation called Program ROSE, that screens patients in Malaysia for cervical cancer, HPV, and other STDs without them ever stepping foot inside a clinic. We introduced self-sampling kits that allow patients to remain anonymous as results can be shared via text message. It is not just about identifying the issue within the community; it is also about working with stakeholders to meet patients where they are, in a way that works for them, without alienating them. 

Countries must continue to build on their progress

It has been encouraging to see governments prioritise and take actionable steps towards addressing women’s cancer care in Asia over the last few years. For instance, Indonesia released their National Cervical Cancer Elimination Plan in 2023 and is committed to strengthening early cancer detection services for breast cancer and cervical cancer, among others. Thailand also approved the inclusion of breast cancer screening mammograms and ultrasounds to its Benefit Package for women aged 40 and above that have a family history of the illness.

We’ve also seen the emergence of regional collaborations such as the APAC WCC, which are bringing together partners who are committed to making progress towards women centric care and tackle the growing issue of women’s cancer. Multi-stakeholder initiatives such as these can amplify and intensify regional efforts by encouraging stakeholders across different markets to share best practices and resources, ultimately bringing these solutions more effectively to patients. 

But we must keep up this momentum to ensure that women in Asia have access to cancer screening to enable early diagnosis and management of diseases such as breast and cervical cancer. Cross-sectoral collaboration is essential in ensuring that we have access to the latest data sets to inform national policies and patient centric public health programs to address health disparities among different patient demographics. Policies and public health initiatives must center around advancing health equity and addressing health disparities among various demographics, including marginalized groups, to ensure that all women have access to the right cancer care, at the right time and where they live.

We know that a woman's health not only impacts her as an individual but also has a lasting impact on the health of those around her, including children, family and her broader community, so it is critical that we prioritise protecting the health of each and every woman. We must work together to ensure that public policy and health initiatives ensure that women gain access to, and benefit from, equitable healthcare for years to come.

Author Bio :

Deepti Saraf is the General Manager of Roche (Malaysia) Sdn Bhd, the pharmaceutical division of Roche. She is also the Vice President of PHAMA, the Malaysian Pharmaceutical  Organisation of Multinational Companies. She also sponsors the APAC Women’s Cancer CAre  Coalition.  

Deepti brings with her 20 years of experience in the pharmaceutical industry in India and  Thailand. She has worked across multiple disease areas including Primary care, Oncology,  Comprehensive Genomic Profiling, I2O and Nephrology. She has worked to establish a rural  healthcare commercial model in India and has developed a comprehensive and integrated  access strategy for Roche in India. In Thailand, she worked with the Thai healthcare system  to implement the Thai Genomics version 4.0 enabling Thai patients to have better outcomes  with personalized healthcare. She has been part of leadership teams in both India and  Thailand. Deepti also successfully led the agile transformation of the Thai affiliate as Chief  Transformation Officer in 2019 and played a key role in above-country ecosystem-shaping  initiatives such as Mission Leapfrog to establish an integrated network with external  stakeholders and partners. She has exposure across international markets through her work  on health technology solutions that help build the healthcare infrastructure.  

As a sponsor for the APAC Women’s Cancer Care Coalition, Deepti’s vision is to enable women  in APAC to have better, faster and earlier access to cancer care closer to home. The coalition  brings together various stakeholders and partners in the healthcare industry to advocate for  women’s cancer care issues in the region. 

She is also deeply committed to building a culture that empowers decision making, whilst  encouraging innovation and experimentation that benefit patients. In the APAC region, 

Deepti is very passionate about Women’s healthcare and women’s leadership and mentors  many women in the healthcare sector. She is also mentoring HCPs for City Cancer Challenge  Foundation. She is also the sponsor for women’s cancer initiatives for APAC in Roche.