Cervical cancer screening rates extremely low in Karnataka

Cervical cancer is the second most common cancer, accounting for about 12 per cent of cases, among women in Karnataka. With routine screening, it can be prevented or detected early.

Yet, screening for this cancer in the state is abysmally low. The recent Karnataka Health Vision Group Report points out that surveys show only 0.5 per cent of women in the 15-49 age group in the state have undergone cervix examinations. And in Bengaluru, only 0.2 per cent of women have undergone cervical cancer screenings.

A study published in the BMC Women’s Health Journal this June, found multiple reasons for low screening. The study was jointly conducted by researchers from the Catholic University of Louvain, Belgium, and Manipal Academy of Higher Education, among 607 women in Karnataka. Over half the respondents were unemployed, and a quarter had not finished secondary education. Around 80 per cent had no health insurance, and about the same proportion had no freedom to make decisions about their healthcare expenses.

The study found that lack of awareness was a major reason for the low levels of screening. Of all respondents, 62 per cent had never heard of cervical cancer and 87 per cent did not know anybody who had the disease. Nearly 90 per cent were unaware that the Human Papillomavirus (HPV) causing cervical cancer was transmitted through sexual contact. Besides, 95 per cent respondents were unaware of the screening and the need for regular screening.

This indicates that, even though information on cervical cancer is available on government websites, the government may have to create awareness through alternative ways such as communities, schools, etc., says the study.

Forty-one per cent of the respondents expressed their intention to undergo screenings in future. But the intention was associated with having a health insurance, being able to make healthcare decisions for themselves, having adequate health literacy and also accessibility to screening centres. That is, women lacking such circumstances faced significant barriers.

The study also found that psychosocial factors influenced the decision to undergo screening. Women who perceived screening to be beneficial and perceived fewer barriers to it were more likely to undergo it. Further, emotions like fear, anxiety or embarrassment were found to be major barriers.

“Unlike most other types of cancer, there is a standard screening programme to help prevent cervical cancer. Unfortunately, this is not made use of,” says Dr Rajashekar Jaka, surgical oncologist. A lot of times, people are reluctant to get tested even if they have symptoms. Awareness is lower in rural areas especially. Government should conduct mass awareness programmes about the disease, screening and vaccination. Cervical cancers can be prevented with Pap smear test every three years, or a combined Pap smear-HPV test every five years,” he says.