Exploring the Context of Cancer Treatment in India
-Cecilia Van Hollen, Associate Professor of Anthropology
Cancer is the second leading
cause of death worldwide and is on the rise in India today. Unlike most regions
of the world, in India the incidence of new cancers is higher among women than
men. Cervical cancer is the most common cancer among women in India and more
women die from cervical cancer in India than anywhere else in the world.
Reported rates of breast cancer are escalating in India and breast cancer is
predicted to overtake cervical cancer as the most common type of cancer; it has
already done so in major cities. With proper resources, cervical cancer is a
curable disease if detected early and success rates for treating breast cancer,
if detected early and with access to advanced medical interventions, have been
remarkable. Regular screening for these cancers has, however, not been widely
practiced as a basic public health measure throughout India largely due to cost
factors. As a result, mortality rates associated with these cancers have been
high. That is beginning to change. A concerted effort is underway on the part
of the national and state governments, NGOs, and multilateral interna-tional
aid organizations to roll out newly discov-ered cost-effective ways to screen
women for these cancers using a combination of new techniques of visual
inspection for cervical cancer, together with clinical and self-breast exam
educational programs.
The success of these screening initiatives depends on
whether women will opt to undergo screenings when they are made available and
whether they seek and receive appropriate treat-ment when they receive a
positive cancer diagno-sis. Initial responses have been uneven across and
within diverse states in India and it is crucial to understand why. In the
Summer of 2015, with a grant from the American Institute of Indian Studies, and
with the assistance of Shibani Rathnam (SU undergraduate public health major)
and Shweta Krishnan (graduate student in anthro-pology at George Washington
University), I conducted research on social and cultural percep-tions and
practices surrounding cervical and breast cancer screening and treatment
programs in low-income communities in Tamil Nadu, South India. I will continue
this work in during the 2016 summer and will expand my study to states in North
India. Rather than approaching this by assuming that people do not engage in
screening or treatment simply because they lack awareness, as many public
health studies do, as a medical anthropologist, my study explores more broadly
the meanings people give to these two forms of cancer and how people situate
the screening and treatment programs for these cancers within the larger
political and economic circumstances of their health and healthcare, and within
the contexts of ideas and practices surrounding gender, sexuality, and women’s
reproductive bodies.