By The Sampadak Express
Cancer is one of the leading causes of death in India, and its burden continues to grow as the country grapples with a rising incidence of various types of cancer. Early detection through effective screening programs plays a critical role in improving survival rates and reducing the severity of the disease. However, in India, cancer screening rates remain alarmingly low, with significant disparities between men and women. While there is a common perception that women are screened more often due to structured programs for breast and cervical cancer, the data suggests that this is not necessarily the case. The gendered approach to cancer screening has led to a false assumption of better coverage for women, even though both men and women face significant barriers in accessing screening.
Are Women Screened More Than Men?
The debate about gender-specific screening rates hinges on the availability of programs for breast and cervical cancer screening, which are more structured and widespread in India than those for cancers more prevalent among men, such as oral, lung, and stomach cancers. According to the National Family Health Survey (NFHS-5), the statistics reveal troubling trends in cancer screening participation across genders.
Among women aged 30-49, only a small percentage have undergone cervical cancer screening: 2.2% in urban areas and 1.7% in rural areas. Similarly, only 1.2% of women in urban areas and 0.7% in rural areas have undergone a breast examination. These figures highlight that the targeted efforts to screen women for breast and cervical cancer are failing to reach most of the population. On the other hand, a similar percentage of men, specifically 1.2%, have undergone an oral cancer screening (1% in urban areas vs. 1.3% in rural areas). While breast and cervical cancer screenings are available, their uptake remains alarmingly low.
This gap is compounded by the absence of structured screening programs for cancers that have higher male prevalence, such as lung, oral, and stomach cancer. The lack of organized screening for these cancers means that men are often left without adequate opportunities for early detection. As a result, it is clear that the issue of low screening rates is not a gender-specific problem but a systemic one that affects both men and women.
The Challenges of Poor Cancer Screening Rates
India’s approach to cancer screening is highly fragmented, relying primarily on opportunistic screenings rather than a nationwide, organized screening program. This piecemeal approach often misses high-risk populations, particularly those in rural areas, where access to healthcare is already limited. This lack of systematic screening has dire consequences: a large proportion of cancer cases in India are diagnosed at advanced stages, significantly reducing the chances of survival.
Several key challenges contribute to this dire situation:
1. Weak Cancer Registries: The Ministry of Health and Family Welfare’s National Cancer Registries Programme (NCRP) maintains 36 Population-Based Cancer Registries (PBCRs) and 236 Hospital-Based Cancer Registries (HBCRs). However, the accuracy and completeness of these data are hindered by the fact that only 28 PBCRs and 58 HBCRs are currently active and reporting data in full. The absence of accurate data prevents healthcare authorities from having a clear understanding of cancer prevalence and trends, hindering efforts to implement effective prevention and treatment strategies.
2. Underreporting and Incomplete Data: Cancer is not a notifiable disease in India, meaning that healthcare providers are not legally bound to report cancer cases. As a result, cancer data remains fragmented, incomplete, and often underreported, particularly in smaller healthcare facilities. This lack of comprehensive data further exacerbates the problem, making it difficult to identify at-risk populations and design targeted intervention programs.
3. Economic and Social Barriers: Fear, stigma, and lack of awareness about cancer prevent many people from seeking screening. In addition to these psychological barriers, rural populations face significant economic challenges. Many rural areas lack proper screening facilities, and out-of-pocket expenses for screening services are prohibitively high. Without government support or affordable healthcare options, lower-income individuals often deprioritize preventive care, which worsens cancer outcomes in the country.
Bridging the Cancer Screening Gap
Given the current challenges, there is an urgent need to reform cancer screening in India. A multi-faceted approach is required to ensure that cancer screening programs are accessible, inclusive, and effective. Key strategies include:
1. Make Cancer Screening Gender-Inclusive: The country must implement structured screening programs for cancers with high male prevalence, such as lung, oral, and stomach cancer. Just as breast and cervical cancer screening programs exist for women, similar efforts should be made to address cancers that disproportionately affect men.
2. Increase Public Awareness: Public awareness campaigns about the importance of cancer screening and early detection must be significantly scaled up. Such campaigns can educate the public on the risks of cancer, the types of screening available, and when and where to get screened. Knowledge dissemination through media channels, community health initiatives, and public service announcements is crucial for increasing participation.
3. Enhance Accessibility: Expanding screening centers beyond urban areas is essential to ensure equitable access to cancer screening for all Indians, especially those in rural regions. Integrating cancer screenings with routine health check-ups in both public and private healthcare facilities can help encourage more people to get screened and reduce the barriers to accessing care.
4. Strengthen Cancer Registries: To improve data collection, it is essential to make cancer a notifiable disease, requiring healthcare providers to report all cancer cases. Strengthening cancer registries will help generate accurate data, enabling better policy formulation and the design of targeted cancer prevention programs.
Government Efforts and the Road Ahead
Encouragingly, the Indian government has already taken steps to strengthen cancer prevention and early detection efforts. In the Union Budget for 2024-25, the government introduced plans to promote the Human Papillomavirus (HPV) vaccination for girls aged 9-14, which is an important preventive measure against cervical cancer. Furthermore, in the Union Budget for 2025-26, the government announced its intention to expand cancer screening initiatives to encourage early diagnosis.
These steps are promising, but much more needs to be done to ensure that cancer screening becomes widely accessible and inclusive. A concerted effort by the government, healthcare providers, and the public is required to close the cancer screening gap and ensure that every individual, regardless of gender, has the opportunity for early detection and improved survival outcomes.
By addressing the systemic barriers to cancer screening and expanding efforts across the country, India can make significant strides in reducing the burden of cancer and improving the overall health of its population. With continued focus and effective execution, India can ensure that early detection and treatment benefits everyone, paving the way for a healthier future.
