Cervical cancer is the second highest cause of cancer mortality in Indian women with 67,477 reported deaths in 2012 and 83,370 estimated deaths in 2020. Pap Smear, an affordable screening test, has shown to reduce mortality by 50 - 80% in various developed countries. However, low cervical cancer screening rate (3.1%) in India has resulted in about 70% of cases being diagnosed at an advanced stage (stage III or IV). The aim of this study is to understand reasons behind lack of voluntary testing among those educated Indians who are above poverty line and who are aware of cervical cancer being a preventable disease.
We designed a two-part web-based questionnaire containing 18 questions (∼90% multiple choice questions). While the first part was designed to capture demographic attributes of the participants, the second part aimed to understand reasons behind low screening levels. The study was distributed between 1st of January 2017 to 30th of April 2017 through social media.
We received a total of 212 responses. After excluding participants who are not currently residing in India or who did not complete the survey, we had 167 evaluable responses. Notably, about 50% (n = 84) of valid participants were aware of cervical cancer, indicating a decent level of awareness among the evaluable population. Among respondents who were aware of cervical cancer, 75% (n = 63) were aware that cervical cancer is preventable by regular screening. However, only 22% of 63 respondents (n = 14) underwent or took their family members for cervical cancer screening. Out of the 49 participants who did not get tested, despite being aware that cervical cancer is preventable, 57% (n = 28) stated time, 18% (n = 9) stated lack of access, and 4% (n = 2) mentioned affordability as a constraint. The remaining 21% gave other reasons most of which are related to the belief that they or their family members have low probability of falling victim to cervical cancer.
Time constraint emerged as the predominant reason for low cervical cancer screening levels among educated Indians who are above poverty line. We propose a proactive approach wherein stakeholders organise well-advertised, easily-accessible screening camps in the residential areas during weekends.
Clinical trial identification
Legal entity responsible for the study
A. Shukla, R.M. Dokala, J.R. Philomen: Acts as an advisory firm offering research and consulting services and regularly interact with health care professionals to understand their evolving views. This research work has no commercial interest and is part of our social outreach initiative.