Abstract
Background:Breast cancer is reported to be the most common cancer among women in India with a high mortality to incidence ratio. Late presentation, driven by lack of awareness and limited accessibility to health services are some of the stated reasons for this. Given this context, this qualitative study was carried out to understand the perception of rural women towards the disease and factors that influenced utilization of available screening services among them. Methods:Forty-four rural women aged 20-60 years from a coastal province in southern India participated in four Focus Group Discussions (FGDs) that were conducted to understand their perception, attitudes and barriers towards breast cancer screening. Participants were identified from the community through purposive sampling and constituted of home makers and working women. The FGDs were led by trained facilitators and the discussions recorded. Ideas and concepts that emerged were listed as codes. Related and similar codes were grouped to form six themes. Results:Women in the study belonged to low- and middle-income households with a mean age of 42.8 ± 7.8 years and almost all had attended school. Although the respondents exhibited fairly good knowledge about the disease, cultural inhibitions, forgetfulness, economic constraints and apprehension towards tertiary health care facility were some of the barriers reported in the uptake of screening services. Participants hailed the role of female health care providers as motivational figures and stressed the need for easily comprehensible information dissemination strategies besides expecting an equal participation of men in issues involving women’s health. Conclusion:Involving cancer survivors as educators and empowering men on women’s health in addition to the felt need of a patient advocate to improve accessibility were some of the highlights of the discussions. Addressing these could go a long way in improving the cancer care continuum in the region.
Highlights
The rising burden of breast cancer in developing economies like India has been quite noticeable (Bray et al, 2018)
Forty-four rural women aged 20-60 years from a coastal province in southern India participated in four Focus Group Discussions (FGDs) that were conducted to understand their perception, attitudes and barriers towards breast cancer screening
The respondents exhibited fairly good knowledge about the disease, cultural inhibitions, forgetfulness, economic constraints and apprehension towards tertiary health care facility were some of the barriers reported in the uptake of screening services
Summary
The rising burden of breast cancer in developing economies like India has been quite noticeable (Bray et al, 2018) This is further corroborated by the national cancer registries data that indicate a high age adjusted incidence rate and a high mortality to incidence ratio (Malvia et al, 2017). Existing sporadic screening services on the other hand, are seldom used either due to prohibitive costs or prevailing cultural factors (Vidyarthi et al, 2013; Salian et al, 2015) Added to this is the inaccessibility of affordable treatment facilities and collectively these account for poor quality of life and survival rates among women with breast cancer in India. Addressing these could go a long way in improving the cancer care continuum in the region
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