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.