Published Apr 07, 2026 | 7:00 AM ⚊ Updated Apr 07, 2026 | 7:00 AM
The World Health Organization has recommended including HPV vaccines in national immunisation programmes, particularly for girls aged 9-14, to significantly reduce the risk of infection.
Synopsis: Women in Tamil Nadu are dropping out of cervical cancer care midway, a government-backed screening survey has found. Experts say fear, poor counselling, and uneven access to services are preventing many from completing the care, despite programmes being in place.
Many women in Tamil Nadu are dropping out of cervical cancer care midway because of fear, confusion, and a lack of guidance.
This finding is from a study published in Scientific Reports, based on a government-backed survey conducted by researchers from the ICMR-National Institute of Epidemiology in collaboration with the Tamil Nadu government.
“About 10% of women were screened for cervical cancer, and among those screened, only 57% of screen-positive women were referred for colposcopy,” the study found, pointing to major breaks in the care cascade.
The study surveyed 4,184 women aged 30–69 across Tamil Nadu and found that screening coverage remains far below global targets. While Tamil Nadu performs better than the national average, it is still significantly short of the World Health Organisation’s 70% screening goal.
“Among the women screened, 26% were screen-positive, but only 15% were referred for colposcopy, and 13% actually underwent the procedure,” the authors noted, highlighting the sharp drop after initial screening.
The study identified the referral stage for colposcopy as the biggest bottleneck, suggesting gaps in both health system processes and patient follow-through.
It also found that nearly 79% of women who were never screened said they had not felt the need, as they “felt normal,” while others cited a lack of awareness about where and how to get tested.
Doctors said these numbers reflected a deeper, often overlooked issue — fear and a lack of communication around procedures.
“A major reason women drop out after screening is the lack of proper counselling. Many patients are not clearly informed what procedures like colposcopy involve — whether it is painful, why it is needed, or what the next steps are,” said Dr Sivaram Ganesamoni, Head of the Department and Senior Consultant, Surgical Oncology, MGM Cancer Institute.
“When people don’t understand, fear takes over, and they tend to avoid follow-up care,” he told South First.
He stressed that fear around cancer itself continues to shape patient behaviour.
“Fear is still very real when it comes to cancer. If that fear is not addressed, it leads to a sense of avoidance. Patients may assume the procedure is harmful or unnecessary and simply don’t return,” he said.
The study itself echoes this, noting that fear of diagnosis, stigma, and embarrassment remain key barriers to screening and follow-up, alongside low awareness.
Experts said this gap is particularly visible in public healthcare settings, where time and infrastructure for counselling are limited.
“In many public settings, there is very little time or infrastructure for one-on-one counselling. In the private sector, because care is paid for, there is more time spent with patients, which improves understanding and follow-up,” Dr Ganesamoni added.
One of the study’s key findings is the significant role played by private healthcare providers.
“Nearly 60% of women who underwent screening did so in private facilities, compared to 40% in government facilities,” the study noted, with the preference even more pronounced in urban areas.
Doctors said this is not just about access, but perception.
“Patients often feel more comfortable in private facilities — they perceive them as cleaner, more organised, and more attentive. These basic factors play a big role in where they choose to go,” said Dr Ganesamoni.
However, this shift raises concerns about data gaps and quality standardisation, as private sector screenings are not always captured in public health records.
The study also pointed out that different screening methods are used in private settings, and their quality and follow-up mechanisms remain unclear.
Beyond infrastructure, experts pointed to a deeper issue of trust in the public health system.
There is a clear gap between public and private care. Even people working within the system, including policymakers and public officials, often do not use public healthcare themselves, Dr Ganesamoni noted.
“Until those shaping the system start using it and have confidence in it, this gap will continue,” he said.
This divide, he added, directly influences patient choices and contributes to uneven care outcomes.
Public health experts, however, noted that Tamil Nadu still stands ahead of many states in cancer surveillance and infrastructure.
“The state has a comprehensive, population-based cancer registry, which gives us a clearer picture of disease patterns, but what we continue to see is that cervical cancer remains more prevalent among women in rural areas, even as other cancers like breast cancer are rising in urban populations,” said Dr R Swaminathan, Associate Director and Professor & Head of the Department of Epidemiology, Biostatistics and Cancer Registry at the Adyar Cancer Institute (WIA).
He noted that while services have expanded, access to complete care remains uneven.
“While the government has expanded screening programmes and oncology services across districts, access to complete care is still uneven due to many factors such as fear, stigma and lack of information,” he told South First.
He added that not all centres are equipped for advanced diagnostics or treatment, forcing many patients to travel and affecting continuity of care.
Participation in cervical cancer screening continues to remain a challenge, despite the availability of programmes across the state.
“Participation in screening also remains lower than expected. Despite programmes being in place, awareness, stigma, and hesitation around cancer continue to delay early detection,” Dr Swaminathan said.
While Tamil Nadu may be ahead in infrastructure, he cautioned that gaps remain for many women, particularly in accessing complete care.
“For many women, especially in underserved areas, access and follow-up care are still significant challenges.”
The study called for strengthening referral systems, improving patient-provider communication, and addressing structural barriers such as travel and cost.
It also underlines the need for better integration of private sector data and stronger quality oversight across all providers.
At its core, experts said, the issue is simple — unless fear is addressed and patients are clearly guided through the process, screening alone will not save lives.
