GS Paper I

News Excerpt:

Only 1% of women are being screened for cervical cancer in India, despite the World Health Organization’s recommendation that at least 70% of women should get tested.

• The share of women screened remains around the 1% mark for oral and breast cancer, too.

About:

• The participation of women in cervical cancer screening in India is extremely inadequate. 
  • A study in an urban community in South India found that only 7.1% of women aged 25-65 had undergone cervical cancer screening at least once in their lifetime.

• The low participation is attributed to various factors such as lack of knowledge, socioeconomic status, and religious affiliation.

• The prevalence of cervical cancer screening in India is significantly lower than that in developed countries, where 68%–84% of women are being screened.
• This highlights the urgent need for improved awareness and access to screening programs in India to reduce the burden of cervical cancer.

What are the reasons for low cervical cancer screening rates in India?

• Socioeconomic Factors: Screening prevalence is associated with education, wealth, and urban residence. The National Family Health Survey found that screening prevalence was higher among women with higher levels of education and household wealth and urban residents.
• Additionally, wealth-based inequality exists in the prevalence of cervical cancer screening, with the rich having higher screening rates.
• The share of women screened for cervical, breast, and oral cancer stood at 1.2%, 0.6% and 0.7%, respectively, as of 2019-21. In contrast, the share of women screened for cervical cancer in advanced economies such as Sweden, Ireland, the U.S. and the U.K. was more than 70%.
• Even if only comparable economies were considered, India lagged far behind. Chart 2 shows the share of women aged 30-49 who were screened for cervical cancer as of 2019 in BRICS nations. 
• Russia led the list with 93%, followed by 58% in Brazil and 52% in South Africa. In India, Egypt and Ethiopia, coverage was less than 5%.
• Healthcare Infrastructure and Investment: Low investment in healthcare infrastructure and the absence of a nationwide government-sponsored screening program contribute to the low screening rates. 
• The lack of an organised mass screening program for early detection of cervical cancer further exacerbates the situation.
• A look at Tamil Nadu’s data throws light on the way forward and some potential pain points. Chart 3 shows that even in the State with the highest screening share, most tests were conducted among older women.
• A recent survey published by Apollo Hospitals, which analysed 1.5 lakh of its health screenings in five years, found that 25% of breast cancer incidence occurred in women aged under 40 years in India.

• Geographic Disparities: There are significant geographic variations in screening prevalence, with some regions exhibiting higher prevalence than others. For example, the South, West, and Central regions have significantly higher cervical cancer screening prevalence than the North-East and Northern regions.
  • Chart 4 shows the share of women screened for cervical cancer in Tamil Nadu across various levels of schooling. 
  • Over 10% of women who completed less than five years and between five and seven years of schooling in Tamil Nadu were screened for cervical cancer. The share reduced considerably as the years of school education increased.
  • Chart 5 shows the share of women screened for cervical and breast cancer in Tamil Nadu across social groups. The share of women screened from Scheduled Castes, Scheduled Tribes and Other Backward Classes communities was higher compared to other communities.
• Lack of Awareness: A study in an urban community in South India found that almost 85% of the surveyed women had poor knowledge of cervical cancer, and less than 25% were aware of its risk factors or preventive measures.
  • Data from Charts 4 and 5 show how state intervention helped Tamil Nadu achieve respectable screening levels. 
  • It shows that State-sponsored screening drives at government health centres make cancer testing accessible to low-income groups as well. 
  • It also shows that lack of awareness is not the only factor behind poor cancer detection, as higher education levels have not led to more screenings.

Way Forward:

Addressing these factors through improved awareness programs, targeted interventions for underserved populations, and investment in healthcare infrastructure is crucial to increasing the uptake of cervical cancer screening in India.