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Low participation in cancer screening in India: a scoping review of breast and cervical cancer programs

J. Venghateri,Priyansh Nathani,Shreya Goyal,B. Sarang,Harshal Rawtani,P. Patil,Deepa Kv,Nethra Jain,A. Gadgil,Nobhojit Roy

Published 2025 in BMC Cancer

ABSTRACT

India is witnessing a high and rising burden of breast and cervical cancers. More than one-third of cases in India are attributed to these two cancers. Early detection and access to affordable and timely treatment are known to reduce the burden of cancer-related deaths. Low and Middle-Income Countries (LMICs) face significant challenges in implementing organized early-detection programs due to inadequate resources, contributing to high mortality from these cancers. Recognizing this critical public health issue, this study evaluates the published literature and government reports on the implementation of breast and cervical cancer screening programs in India. Literature was systematically searched from six databases: PubMed, Embase, Scopus, CINAHL, Web of Science, and Google Scholar. In addition, reports on the National Health Mission website were reviewed to capture screening efforts that were not published in the peer-reviewed literature. 59 peer-reviewed manuscripts were identified, from 57 screening programs. The number of screening programs from Northern and Eastern states is low. Community programs focused on task shifting and engagement of local stakeholders for increasing participation. Clinical Breast Examination (CBE) and Visual inspection of the cervix (VIA) remain the mainstay of screening efforts. The main barriers to screening uptake by women were lower education, lower socioeconomic status, lack of transportation, and suboptimal services. Information on screening programs lacked uniformity in reporting and data collection. These results highlight that screening efforts in India remain disjointed and programs by different agencies need to be aligned through uniform distribution, methodology, and reporting, towards goals set by global initiatives.

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