The Rising Incidence of Breast Cancer among Women under 40 in Bangladesh: Causes and Screening Challenges

Abstract

Background: Breast cancer is increasingly affecting younger women worldwide, with a concerning rise in incidence observed among Bangladeshi women under the age of 40. Limited awareness, sociocultural barriers, and delayed screening contribute significantly to late-stage diagnosis and poor outcomes in this demographic. Aim of the study: To investigate the contributing risk factors, screening practices, tumor characteristics, and barriers to early detection of breast cancer among women under 40 in Bangladesh, with a focus on urban–rural disparities. Methods: This cross-sectional study included 150 histopathologically confirmed breast cancer patients aged below 40 years from two tertiary care centers in Bangladesh. Sociodemographic data, risk factors, screening behavior, tumor characteristics, and reported barriers to early screening were collected using structured interviews. Statistical analyses included chi-square tests, logistic regression, and odds ratio (OR) calculations to identify associations between variables and late-stage diagnosis. Result: The mean age was 32.6 ± 4.7 years; 56.7% resided in urban areas. Early menarche (26.7%), hormonal contraceptive use ≥5 years (29.3%), obesity (34.7%), and sedentary lifestyle (52.7%) were significantly associated with urban residence (p < 0.05). Despite a high prevalence of modifiable risk factors, 63.3% of participants had never undergone any form of screening. Tumor size >2 cm was present in 87.3%, and 56.7% were diagnosed at advanced stages (III/IV). Invasive ductal carcinoma was the predominant histology (87.3%). Major barriers to early screening included lack of awareness (58.7%), financial constraints (42.7%), and fear of diagnosis (36.7%). Lack of awareness (OR: 2.38, 95% CI: 1.29–4.39) and financial barriers (OR: 2.67, 95% CI: 1.37–5.21) were strong predictors of late-stage diagnosis. Conclusion: The increasing burden of breast cancer among young Bangladeshi women is compounded by modifiable risk factors, limited screening uptake, and systemic barriers to early detection. Targeted awareness programs, improved access to diagnostic services, and culturally sensitive interventions are urgently needed to promote early diagnosis and improve survival outcomes in this vulnerable population.