Breast Cancer in Iraq: Understanding Patient Outcomes and Barriers to Treatment

Background: In Iraq, breast cancer poses an unprecedented public health risk, with rising incidence rates coupled with complex treatment barriers impacting patients' outcomes. The objective of this study was to explore the state of breast cancer in Iraq, identifying influences on treatment outcomes and on patients´ access to breast cancer care in Iraq.

Methods: From January 2023 to December 2024, we conducted a cross-sectional study at many hospitals in Iraq, including site visits, screening medical records of 847 breast cancer patients´ medical records, studying their treatment pathways and treatment outcomes. Data collected comprised of demographic characteristics, clinical presentations and staging of the cancer, treatment types, and barriers to treatment. We used SPSS version 28.0 for the statistical analyses.

Results: The mean age at diagnosis was 48.2 years (SD ± 11.7). Late-stage presentation were common: 62.4% of patients were staged diagnosed at level III or IV. The overall 5-year survival was 58.3%. Reported barriers to treatment included: financial costs (73.2%), geographic barriers (45.8%), and medication availability (51.7%). We found a statistically significant difference between urban and rural patient outcomes (p<0.001). Multidisciplinary patient care was available for only 34.7% of patients.

Conclusions: Breast cancer outcomes in Iraq are limited due to late presentations, the limited resources, and systemic barriers to treatment. There is an urgent need to implement interventions that improve early detection of breast cancer; increase patients' access to treatment, and strengthen the public health infrastructure to address this important and growing public health issue.