A woman holds up a pink ribbon for awareness of breast cancer. Photo: Angiola Harry/Unsplash.
One in 10 Indians is likely to develop cancer in their lifetime, and one in 15 will die of it, according to a recent World Health Organisation (WHO) study. There are two significant issues that contribute to this state: people with cancer in India present late for appropriate care, and the awareness of various risk factors and preventive aspects of the more common cancers is low.
The recently released fifth National Family Health Survey (NFHS-5) includes estimates of the number of women aged 30-49 years who have ever been screened for cervical, breast or oral cancer. (The data is however restricted to 22 states and UTs, thanks to the COVID-19 pandemic.)
Overall, the accompanying report clearly indicates that cancer awareness and preference for early screening in India is very low.
The fraction of women aged 30-49 years and who have been screened for cervical cancer is lower than 7% in every state. Mizoram leads on this count (6.9%), followed by Andhra Pradesh (4.7%), Kerala (3.5%) and Telangana (3.3%). However, there are prominent intrastate differences, especially up to 7% in Mizoram and around 3% in Himachal Pradesh. The corresponding scores for Nagaland, Ladakh, West Bengal, Gujarat and Assam are 0.1-0.2%.
You may think awareness of the importance of periodic screening is higher among urban women – but Andhra Pradesh, Telangana, Andaman & Nicobar Islands and Bihar buck this expectation.
The case of breast cancer is worse. Mizoram has the highest fraction of women aged 30-49 years who were screened for breast cancer (2.7%), followed by Kerala (2.4%) and Manipur (1.6%). Assam, West Bengal, Gujarat and Sikkim once again populate the bottom.
The awareness of oral cancer is a bit better – although it falls off steeply after Andaman & Nicobar Islands’ 10.1% and Andhra Pradesh’s 7.3%. Bihar, West Bengal, Gujarat and Assam have the lowest values yet again, around 0.2-0.3%.
And once again, more women in rural areas have undergone screening than women from urban areas.
NFHS-5 has for the first time also reported the percentage of men aged 30-49 years who have undergone an examination for oral cancer. And here, the difference between rural and urban areas is more noticeable.
It’s important for India’s men and women to undergo yearly screenings for the cancers that most commonly afflict their demographic group. The launch of the Cancer Awareness Campaign 2019 was a step in this direction, and it was a long time coming.
If people have the right information, follow a healthy lifestyle, are screened regularly and are aware of early signs and symptoms, they are likely to be able to beat the disease.
Bajarang Bahadur, Harshita Chari and Vinod Kumar are research scholars at the International Institute for Population Sciences, Mumbai.