Breast cancer is the most common cancer in urban Indian women and the second most common in rural women. Owing to a lack of awareness of the disease in India and in absence of breast cancer screening programs, the majority of breast cancers are diagnosed at a relatively advanced stage. Government agencies, NGOs, and charity organizations have put great emphasis on improved breast cancer awareness among the masses for the promotion of early detection, providing comprehensive treatment modules, providing support for breast cancer management, and screening and rehabilitation. The efforts have resulted in improved survival and quality of life of Indian breast cancer patients but the improvement is more pronounced in the urban population. In rural areas, there is still a lack of good health care and awareness among the masses regarding the importance of early breast cancer screening and thus cases of late diagnosis are more prevalent. In addition, there is still an identified lack of breast cancer screening programs in rural areas which further causes late diagnosis. The other common factors that lead to late diagnosis include delays on the part of womenfolk of rural areas to seek advice for a recognized health problem which is mainly due to financial reasons, social/cultural reasons such as general inhibition of women to see the doctor for breast ailments, the general scare of people towards cancer like disorders and the general indifference of women towards their health. In rural areas Illiteracy is widespread and also people are inhibited and not motivated to come to the hospitals for screening/check-ups.
Considering various factors of cancer incidence rate, to address the most common barriers such as lower cancer literacy, lesser availability, and accessibility of proper medical facilities, three Indian states were shortlisted to initiate the project “ECHO” by organizing Breast Cancer Awareness and Screening Programs for Rural and Semi-Urban Indian Population. In addition to being a CSR approach, Project ECHO also increased cancer literacy amongst the rural population and emphasized health education, early diagnosis of breast cancers, and more public facilities for breast cancer treatments.