Q COSTA RICA — It is no secret that cancer is a deadly disease that does not pause to wait for medical appointments, lab tests, radiological imaging, surgeries, radiation therapy, or chemotherapy.
Consequently, waiting lists for breast cancer treatment can pose a dangerous threat to women in Costa Rica.
As of March of this year, there was a waiting list of 42,000 women for ultrasounds within the CCSS (Caja Costarricense de Seguro Social) system, with wait times exceeding 300 days, according to Wágner Alpízar, a specialist in Cancer Biology and Biochemistry at the Universidad de Costa Rica (UCR)—University of Costa Rica.
The problem is that a four-week delay in curative cancer treatment is associated with an 8% to 12% increase in mortality across multiple cancer types and treatment modalities, the expert explained, citing international studies.
In this regard, Alpízar—who participated in a discussion on breast cancer detection organized by the office of legislator Ángela Aguilar (PLN)—highlighted the importance of making institutional changes to facilitate more timely diagnoses.
“By streamlining processes, we could substantially improve diagnosis and, above all, ensure that the diagnosis translates into rapid treatment. If we diagnose early but time passes without women receiving treatment, then the diagnosis becomes a waste of resources, as it will not translate into improved survival or quality of life for the women,” Alpízar said.
Leading Cancer in Costa Rica
In Costa Rica, between 1,337 and 1,344 new cases of breast cancer are reported annually—an incidence rate of approximately 37.5 to 55 cases per 100,000 women, according to Ministry of Health reports.
In total, more than 426 deaths among women of all ages are recorded each year due to cancer, making it the deadliest cancer for the female population.
Meanwhile, legislator Aguilar—herself a cancer survivor—shared her experience, emphasizing the urgent need to improve the institutional battle against time and to raise awareness among women so they can receive timely care.
“I am here because my cancer was detected in time, which allowed for timely treatment… Prevention and early detection save lives, and that is the message we are conveying,” said Aguilar.
Finally, Roberto Morales, a specialist in gynecologic oncology and obstetrics and gynecology at La Católica International Hospital, stated that women aged 40 to 75 with no risk factors should undergo a mammogram every two years, while those with a family history or predisposing conditions should do so annually.
The Data
In Costa Rica, breast cancer is the most frequently diagnosed malignant tumor and the leading cause of cancer-related mortality among women (Data from the CCSS, the Ministry of Health, and the UCR).
- New cases: Approximately 1,337 to 1,344 new cases are reported annually, equating to an incidence rate of roughly 37.5 to 55 cases per 100,000 women, according to Ministry of Health reports.
- Age group: 70% of new cases occur in women over the age of 50.
- Risk ratio: It is estimated that one in every 20 to 25 women in the country will be diagnosed with this disease during her lifetime.
- Annual deaths: More than 426 deaths per year are recorded among women of all ages (with a mortality rate close to 10.6 or higher per 100,000 women).
- Age at death: Approximately 41% to 45% of deaths occur in women over the age of 70, although the disease also has a significant impact at younger ages (between 30 and 69).
- Geographic distribution: Provinces such as Heredia and Cartago have shown some of the country’s highest mortality rates in recent periods (reaching 18–20 deaths per 100,000 women).
Prevention
Early detection and the adoption of healthy habits remain the most effective tools for reducing the impact of this disease in the country.
- Mammography as the gold standard: This is the primary tool for early detection. It is recommended every two years for women aged 40 to 75, or earlier if there is a direct family history or other risk factors.
- Body awareness (Self-examination): Complements mammography (does not replace it). It allows for the identification of unusual changes such as lumps, dimpling, nipple discharge, changes in skin texture, or swelling in the armpit.
- Healthy lifestyle: Reducing alcohol consumption, maintaining a healthy body weight, engaging in regular physical activity, and avoiding smoking help lower the risk of developing this tumor.
- Timely care at EBAIS/CCSS facilities: If you notice any suspicious signs or fall within the recommended age range, you should schedule an appointment at your local health center. Early detection raises survival rates to over 90%.
Mid-range position
Despite the campaigns conducted in Costa Rica, there is still much work to be done regarding breast cancer detection in the country.
The country falls into a mid-range category compared to other regions (figures represent the number of cases per 100,000 inhabitants, according to the International Agency for Research on Cancer).
Warning signs
Early identification of any unusual changes in the breasts is key to early diagnosis. Recognizing these signs allows for prompt action and seeking medical attention before the disease progresses.
- Lump or thickening: Appearance of a mass, nodule, or hardened area in the breast or underarm, with or without pain.
- Skin changes: Presence of dimpling, redness, scaling, indentations, or an “orange-peel” texture.
- Nipple changes: Retraction or inversion of the nipple, localized pain, scaling, or changes in shape.
- Abnormal discharge: Fluid or blood leaking from the nipple when not breastfeeding.
- Changes in size or shape: Asymmetrical variation, swelling, or increased breast volume without an apparent cause.
National concern
Breast cancer is the most common cancer and the leading cause of death among women in Costa Rica.
Lawmakers, doctors, and other stakeholders are calling for improved care to reduce the number of fatal cases.