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India faces challenges to screen for cervical cancer in rural and underserved areas. There is social stigma and fear of positive result. Lack of awareness about cervical cancer and the importance of screening remains alarmingly low. The fear of being diagnosed with cancer, along with the perceived stigma and emotional distress, discourages many women from undergoing screening.
Cultural taboos surrounding reproductive health and misconceptions linked with HPV testing being associated with promiscuity perpetuate hesitancy and prevent women from seeking preventive services. Additionally, linking screening with invasive procedures and the potential discomfort also perpetuates avoidance. This fear is compounded by a lack of counselling and inadequate support systems to help women manage their anxiety about potential outcomes and the process itself, noted Ravneet Kaur, associate portfolio manager, Evidence 2 Impact, Swasti Health Catalyst.
Although the government has initiated vaccination for the adolescent population in India, this stark reality that critically affects the quality of life of our women underscores the urgent need for coordinated and targeted action through early detection and prevention, emphasizing the critical role of timely screening, said Dr. Syama B Syam, portfolio manager, Evidence 2 impact, Swasti Health Catalyst.
Pointing out that cervical cancer screening is a game-changer, offering a lifeline through early detection, allowing for timely intervention and significantly improving survival rates, Ravneet said, there is need to maximise technology and investments to build robust infrastructure and equipment will be decisive in promoting equitable access to preventive measures like screening.
While HPV DNA testing is a superior method for early detection, its adoption in India is restricted by financial and logistical constraints like inadequate supply chains, limited laboratory networks, and a lack of trained personnel, especially in non-urban settings, she added.
According to WHO, the possibility of self-sampling, allows women to collect samples in the comfort of their own homes. This not only enhances convenience and privacy but also reduces barriers such as fear, embarrassment, and logistical challenges associated with clinic visits. WHO recommends HPV self-sampling as part of its self-care intervention recommendations. By empowering women to take control of their health in a way that fits their lifestyle, self-sampling has the potential to improve women’s participation in cervical cancer screening, particularly in areas with limited access to healthcare facilities, stated both Ravneet and Dr Syama.
The way forward is a unified approach to eliminate cervical cancer. Overcoming challenges requires a multi-faceted approach that combines education, innovation, and systemic reforms. Organized and continuous awareness is crucial for the prevention where women are educated about cervical cancer risks and screening benefits. National campaigns using diverse approaches that is participatory, inclusive and community-led will dismantle myths and foster positive dialogues. Training healthcare providers to encourage preventive screenings as part of broader women and adolescent health interventions will promote early awareness and adoption towards positive practices. Policy level changes like integrating cervical cancer screening as part of national health programmes will grow the elimination efforts, they noted.
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