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Cited by 175Women's cancer prevention and managementGlobal Cancer Incidence and ScreeningCancer survivorship and care

A qualitative exploration of cervical and breast cancer stigma in Karnataka, India

Open access
Nyblade, Laura, Stockton, Melissa, Travasso, Sandra, Krishnan, Suneeta·2017·BMC Women's Health
DOI 10.1186/s12905-017-0407-xPMC PMC5541646
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Abstract

BACKGROUND: Breast and cervical cancer are two of the most common cancers among women worldwide and were the two leading causes of cancer related death for women in India in 2013. While it is recognized that psychosocial and cultural factors influence access to education, prevention, screening and treatment, the role of stigma related to these two cancers has received limited attention. METHODS: Two qualitative exploratory studies. One focusing on cervical cancer, the other on breast cancer, were conducted in Karnataka, India using in-depth interviews and focus group discussions. In the breast cancer study, 59 in-depth interviews were conducted with patients, primary caregivers and healthcare providers. In the cervical cancer study, 147 respondents were interviewed including older and younger women, husbands, healthcare providers and community leaders. While stigma was not the focus of either study, themes relating to stigma emerged and are the focus of this analysis. RESULTS: Cancer stigma emerged as a general theme across both data sets. It appeared throughout the transcripts as descriptions of how women with breast or cervical cancer would be treated and talked about by husbands, family and the community (manifestations of stigma) and the reasons for this behavior. Stigma as a theme also arose through discussions around managing disclosure of a cancer diagnosis. Stigma was juxtaposed with a narrative of support for women with cancer. Three major themes emerged as driving the manifestations of cancer stigma: fear of casual transmission of cancer; personal responsibility for having caused cancer, and; belief in and fear of the inevitability of disability and death with a cancer diagnosis. Manifestations of cancer stigma were described in terms of experienced (enacted) stigma, including isolation or verbal stigma, and anticipated (fear of) stigma, should a cancer diagnosis be disclosed. CONCLUSIONS: The presence in these communities of cancer stigma and its many forms emerged across both the cervical and breast cancer data sets. Stigma was a feared outcome of a cancer diagnosis and described as a barrier to screening, early diagnosis and treatment seeking for women with symptoms. While further research on cancer stigma is needed, this exploration of some of the driving factors provides insight for future programmatic efforts to reduce cancer stigma and improve access to information, screening and treatment.

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  • In India, coverage of VIA cervical screening is low (1.9% ever screened) due to multiple provider- and recipient-related barriers.

    “While India’s current policy solution of Visual Inspection of the cervix with Acetic acid (VIA)2 is primarily based on affordability, the coverage achieved is low (1.9% ever screened)3 due to multiple provider and recipient-related barriers.4”

    From Protocol for a cervical screening implementation trial comparing two approaches for delivering HPV self-collection in low-resource settings in India: a type 3 hybrid cluster randomised controlled trial (SHE-CAN) (2025) · cites this paper as [4]

    The Background identifies healthcare-system and psychosocial barriers to screening, and the Results (Consequences of stigma; Manifestations of stigma) describe fear of stigma and distrust of provider confidentiality as reasons women may avoid cervical screening. But this qualitative study in Karnataka does not establish that those barriers caused India’s low VIA screening coverage. The 1.9% figure is attached to a different citation in the citing sentence. (LLM, conf=0.82)

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  • Challenges to cancer screening in the Indian setting include a historical lack of a culture of prevention, inequality in healthcare access (especially for women), stigma and myths regarding cancer, all of which result in low uptake and follow-up, even when screening and treatment services are available.

    “Challenges to cancer screening in the Indian setting include a historical lack of a ‘culture of prevention’, inequality in healthcare access (especially for women), stigma and myths regarding cancer, all of which result in low uptake and follow-up, even when screening and treatment services are available.4”

    From Protocol for a cervical screening implementation trial comparing two approaches for delivering HPV self-collection in low-resource settings in India: a type 3 hybrid cluster randomised controlled trial (SHE-CAN) (2025) · cites this paper as [4]

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Research works printed but not linked: 1

  1. [41]Suwankhong D, Liamputtong P. Breast cancer treatment: experiences of changes and social stigma among Thai women in southern Thailand. Cancer Nurs. 2015; 25881809

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Authors
Nyblade, L., Stockton, M., Travasso, S., & Krishnan, S.
Affiliations
RTI International (US)
Corresponding author
Nyblade, Laura
ORCID
Venue
BMC Women's Health
Publisher
Springer Science and Business Media LLC
Published
2017-08-02
Volume
17
Issue
1
Pages
58-58
ISSN
1472-6874 (ISSN-L)
DOI
10.1186/s12905-017-0407-x
PMC
PMC5541646
OpenAlex
W2739620956
Cited by
175
References
52
Citations by year
2026: 10 · 2025: 23 · 2024: 23 · 2023: 23 · 2022: 21 · 2021: 29 · 2020: 29 · 2019: 11 · 2018: 6
FWCI
11.81
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Women s Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Cancer Institute (R01CA172542)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
cancer stigma, cervical cancer, breast cancer, women's health, Karnataka, cancer diagnosis disclosure, enacted stigma, anticipated stigma, fear of transmission, social isolation, barriers to cancer screening, treatment seeking
MeSH terms
Adult, Breast Neoplasms, Uterine Cervical Neoplasms, Female, Humans, India, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Acceptance of Health Care, Physical Examination, Focus Groups, Qualitative Research, Early Detection of Cancer, Social Stigma

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