Barriers to Cervical Cancer Screening in India: Insights from National Family Health Survey-5 Data

印度宫颈癌筛查的障碍:来自第五次全国家庭健康调查数据的启示

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Abstract

BACKGROUND: Cervical cancer, one of the commonest malignancies, can be prevented and cured through early diagnosis. Screening plays an important role in its control strategy, and India has dedicated strategies to its implementation. However, screening uptake is low in India. We examined how sociocultural and financial factors affect Indian women's cervical cancer-screening uptake behaviour. METHODS: Cervical cancer screening-uptake and relevant social, cultural, and financial data obtained from round-5 of the National Family Health Survey (NFHS) were used for analysis. We examined 399,039 eligible records to survey cervical cancer screening conduct and assessed the impact of sociocultural barriers on such conduct using logistic regression. Descriptive statistics were used to describe background data. RESULTS: Most participants, aged 30-34 years, were uneducated, homemakers with bank accounts; mobile phone usage was limited, particularly in rural areas. One-third possessed health insurance, and approximately 10% had pre-diagnosed comorbidities. Only 2% underwent cervical cancer screening. Screening uptake was higher among older, educated, employed individuals with bank accounts, phone access, and media exposure. Mothers with more children and perceived constraints against healthcare seeking had lower uptake rates. Tobacco use, insurance, wealth, and media access had contrasting effects in rural and urban settings. CONCLUSION: Sociocultural and monetary factors have an unmistakable influence on cervical cancer screening uptake. Thus, aside from the continuous strengthening of the health system, our findings call for targeted mediations against misguided judgments and taboos alongside financial and social empowerment for better outcomes in India's cancer-screening policy.

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