Why and What are the Challenges?
- Awareness regarding cervical cancer and its prevention is very poor both among educated and illiterate women in India and to a certain extent, even among health care providers. Awareness creation strategies are inadequate in our country.
- Compliance with screening is poor, both because of societal factors and because women being asymptomatic until the disease progresses to an advanced stage.
- In the rural milieu, preventive practice is unheard of and women are reluctant to submit themselves for a gynecologic examination when they are asymptomatic. The main challenge, therefore, lies in creating awareness about the need for screening among both rural and urban women and health care workers.
- The fact that this cancer is indolent and provides a large window of opportunity for early diagnosis and effective therapy is itself becoming a challenge for motivating the women to come for the screening. The tendency to seek health care as a remedy for disease rather than for prevention of disease has become a huge obstacle to screen the community at large. A fundamental alteration of how we perceive our responsibility towards our own health is required. We recognize that awareness creation is the only way to change this mindset. We often use social gatherings that women frequent as venues to deliver short talks about the disease, prevention and the necessity to undergo regular screening tests.
- In rural areas, women are apprehensive of the results of a screening test and fear of the consequences of a positive test. The health of the woman occupies the least priority in many rural households. We have had several women refuse to come for the screening test, despite being symptomatic. These women later developed frank cancer and were thrown out of their houses and abandoned by their families, since their presence was so unbearable to the rest of the family due to the foul odor associated with the later stages of this disease. Cervical cancer is one of the worst cancers to affect human beings. In the later stages of the disease, the patients have severe pain and emit a foul odor due to the tumor.
- Continuing screening and evaluation of the womenfolk and necessary treatment of the women who screen positive for disease. Following up with these women, to convince them to come for treatment is the biggest challenge, both operationally and financially. Treatment costs are high and with the economic challenged background that these women hail from, many opt not to get treated for as long as possible.
- Sustainability and larger reach is another challenge. Unless multiple programs at multiple locations run in parallel, the reach is going to be at a snail’s pace. Sufficient flow of funds on a regular basis becomes extremely important to beat this disease.