Why Are Most Cervical Cancers Diagnosed Late? Oncologist On Changing The Narrative

Cervical cancer is one of the major causes of cancer-related deaths globally, including in India. According to the World Health Organisation (WHO), it is the fourth most common cancer in women worldwide. While Human Papillomavirus (HPV) vaccination and regular screening can prevent the disease, a widespread lack of awareness and deep-rooted social taboos still exist and hinder the treatment.

As January marks Cervical Cancer Awareness Month, the editorial team of Onlymyhealth spoke to Dr Sonia Mathai, Consultant at the Preventive Oncology Department, Tata Medical Centre, Kolkata. Continue reading to know what she shared with us.

The Current Burden of Cervical Cancer in India

Reports indicate that in 2022 alone, India recorded 127,526 new cases and 79,906 deaths related to cervical cancer. While breast cancer has a higher incidence rate, cervical cancer has a significantly higher mortality-to-incidence ratio. This is primarily because it is often diagnosed at a much later stage.

Dr Sonia Mathai notes that this is in stark contrast to developed nations, where early screening leads to high survival rates. “Unlike many other cancers, cervical cancer is preventable through vaccination and regular screening. Its high prevalence in India is a critical public health issue tied to societal inequities. There is also a noticeable geographical variance, with higher rates observed in rural and underserved states,” she explains.

Also Read: Is Vitamin B Good for Arthritis? Find Out Here

Most Diagnosed at an Advanced Stage

It is estimated that 70% of cases in India are diagnosed at an advanced stage (Stage II or beyond). At this stage, treatment becomes not just expensive, but the survival rate also decreases significantly.

Dr Mathai explains, “There is a lack of an organised, nationwide screening programme as we usually rely on opportunistic screening, which often misses at-risk individuals.” “Early symptoms like irregular bleeding or discharge are frequently ignored or normalised until the disease has progressed. Poor referral pathways and a limited number of specialists in smaller towns mean that even when women do seek help, they might not receive proper care promptly,” she continues.

The fear and stigma surrounding gynaecological issues also cause women to delay seeking medical attention until it is too late to treat.

Primary Barriers to Early Screening

Dr Mathai highlights that many Indian women are even unaware that cervical cancer develops in the cervix uteri (the lower part of the uterus) or what the early warning signs are. Many contributing factors lead to a lack of early screening, and ignorance is one of them.

“Only around 20% of women are aware of the Human Papillomavirus (HPV), the virus responsible for the cancer,” she notes. She defines the main barriers using the “Three As”:

Also Read: Why Are Cardiologists Warning Against Early Winter Outings?

Awareness

Despite various campaigns and digital education, many women lack knowledge about HPV and screening methods like Pap smears or HPV tests. Cherry on top, Social stigma regarding sexual health often silences these necessary conversations and curiosity.

Accessibility

Screening centres are frequently limited to urban areas and tertiary hospitals. While urban women comparatively have better access, rural women do not have enough facilities to get tested, and this eventually leads to ignoring the problem.

Affordability

Even when screening is subsidised, indirect costs, such as travel expenses and lost wages, act as a major deterrent for families living in rural India.

Also Read: Ghee Vs Butter – Which Is The Healthier Choice For Cooking?

Understanding the Screening Gap

According to Dr Mathai, the gap between policy and implementation is complex. “India’s vast size and diversity in socio-economic, cultural, and educational backgrounds create unique challenges that make it more difficult to implement a uniform screening programme.”

She also points out the disparities in healthcare infrastructure. "Many rural regions lack adequate facilities, essential equipment, and trained personnel. These gaps prevent the early detection of precancerous lesions and lead to fragmented services and weak referral links," the oncologist highlights.

How Can We Encourage More Women to Get Screened?

Dr Mathai suggests the following strategies to address the screening gap:

Community Education

We must involve communities in culturally sensitive campaigns to dispel myths. Normalising conversations about gynaecological health informs women that the disease is not just preventable and treatable but also common.

Role Models

Bringing survivor stories, local influencers, and healthcare workers to the doorsteps may encourage women to prioritise their health, as finding relatable stories significantly reduces fear.

Empowerment

Public health campaigns, financial independence and self-reliance play a crucial role in motivating women to prioritise their health.

Also Read: Tokophobia: Doctor Explains How You Can Deal With Your Fear of Pregnancy

Challenges to Overcome

To deal with the rising cases of cervical cancer, there is a great need to address limited screening coverage and low HPV vaccine uptake. Here are a few necessary steps outlined by Dr Mathai:

Vaccination

HPV vaccination should be integrated into the existing healthcare system through school-based and community programmes to protect adolescent girls early.

Medical Infrastructure

We need robust pathways for screening and follow-up, particularly in rural areas, ensuring a trained workforce is available for consistent service.

Digital Coordination

A strong digital system at the central and district levels is critical for real-time tracking of screenings, follow-up reminders, and vaccination coverage.

Community Engagement

Deep-rooted challenges like a lack of autonomy and social stigma also need to be addressed through long-term community engagement and women-centric health programmes.

Bottomline

In cases of cervical cancer, many women feel screening is unnecessary until they notice some severe symptoms. Overcoming this mindset is a major challenge that requires both community education and systemic reform. To manage the rising cases of Cervical Cancer, local involvement and a message that it is preventable, detectable, and treatable is paramount.