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Cancer Awareness and Stigma in Rural Assam India: Baseline Survey of the Detect Early and Save Her/Him (DESH) Program

  • Global Health Services Research
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

India has an estimated incidence of more than one million cancers annually. Breast, oral, and cervical cancers account for over one-third of newly diagnosed cases. With the introduction of pilot cancer screening programs in India, little is known about current sociocultural barriers that may hinder acceptance of screening and treatment. We sought to identify knowledge gaps, misconceptions, and stigmas surrounding cancer diagnosis.

Patients and Methods

A baseline survey was conducted in Assam, India, as part of the Detect Early and Save Her/Him program, a mobile screening program for breast, oral, and cervical cancer. Data were collected on participants’ cancer knowledge, and attitudes towards screening, diagnosis, and treatment.

Results

Of the 923 residents who participated, a large majority (92.9%; n = 858) were neither aware of cancer screening availability nor had prior screening. Low-medium awareness was demonstrated regarding the carcinogenic effects of betel nuts (n = 433, 47%). Only one-third of participants recognized oral ulcers and dysphagia as cancer symptoms. Approximately 10% of respondents had misconceptions about cancer etiologies, and 42–57% endorsed statements reflecting a negative stigma towards cancer, including its long-term detrimental effects on personal, occupational, and familial life. However, the majority (68–96%) agreed with statements endorsing positive community support and medical care for cancer patients.

Conclusions

This study identifies actionable targets for intervention in cancer education and awareness within a large rural Indian population. Education to address preventable causes of cancer and to correct misconceptions and stigma is a critical component in ensuring the successful implementation of cancer screening programs.

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Funding

This study was funded by the Piramal Swasthya Management and Research Institute. Dr. Golshan received support from the Breast Cancer Research Foundation.

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Authors and Affiliations

  1. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Linda M. Pak MD & Mehra Golshan MD, MBA

  2. Piramal Swasthya Management and Research Institute, Hyderabad, India

    Chetan C. Purad MBBS, MHSc, MBA, Sudheer Nadipally MS, Madhusudhana P. Rao BCom, MBA, Sudeshna Mukherjee MBA & Shailendra K. B. Hegde MD, MBA

  3. Dana Farber/Brigham and Women’s Cancer Center Boston, Boston, MA, USA

    Mehra Golshan MD, MBA

  4. Yale New Haven Hospital, New Haven, CT, USA

    Mehra Golshan MD, MBA

Authors
  1. Linda M. Pak MD
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  2. Chetan C. Purad MBBS, MHSc, MBA
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  3. Sudheer Nadipally MS
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  4. Madhusudhana P. Rao BCom, MBA
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  5. Sudeshna Mukherjee MBA
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  6. Shailendra K. B. Hegde MD, MBA
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  7. Mehra Golshan MD, MBA
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Correspondence to Linda M. Pak MD.

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DESH baseline survey questionnaire (PDF 3676 kb)

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Pak, L.M., Purad, C.C., Nadipally, S. et al. Cancer Awareness and Stigma in Rural Assam India: Baseline Survey of the Detect Early and Save Her/Him (DESH) Program. Ann Surg Oncol 28, 7006–7013 (2021). https://doi.org/10.1245/s10434-021-10366-7

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  • DOI: https://doi.org/10.1245/s10434-021-10366-7

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