Does women’s empowerment and their socioeconomic condition affect the uptake of breast cancer screening? Findings from NFHS-5, India

Abstract

Background Screening for breast cancer results in early diagnosis of the disease and improves survival. However, increasing participation of women in screening programs is challenging since it is influenced by socioeconomic and cultural factors. This study explores the relationship of socioeconomic and women empowerment factors with breast cancer screening uptakes in the states and union territories of India. Methods We used summary reports of secondary data from all the states and union territories based on the fifth wave of the National Family Health Survey in India. This ecological study compares the uptake of breast cancer screening across states of India. We considered socioeconomic status (SES) and women empowerment status (WES) indicators from the survey as independent variables and state-wise breast cancer screening uptake as dependent variables for studying their association. The determinants of breast cancer screening were calculated using a simple linear regression model. Results We found that socioeconomic status and women empowerment status moderately correlated with breast cancer screening uptake (correlation coefficient 0.34 and 0.38, respectively). States with higher rates of literacy among women and of women who had their own bank accounts that they decided how to use reported higher uptake of breast cancer screening (p = 0.01 and 0.03, respectively). However, the correlation was not uniform across all the states. The states of Chandigarh, Delhi, Telangana, and Karnataka showed lower participation despite a higher percentage of literate women and women with their own bank accounts. Conclusion This study indicates that women’s literacy and having their own bank account may moderately improve their participation in cancer screening. However, higher SES and WES did not translate into better screening in many of the states. More research is needed, especially for states which had low screening uptake despite relatively higher rates of women empowerment.

Recognising socio-cultural barriers while seeking early detection services for breast cancer: a study from a Universal Health Coverage setting in India

“…Traditional male authoritarian leadership shapes hierarchical relationships in a joint family in India: male sons must defer to their fathers, and women, especially daughters-in-law, are considered subordinate, lacking decision-making ability [ 30 ]. Recent work by the author team assessing the effect of women empowerment indices on screening uptake also showed similar findings: women who lack autonomy to make decisions in the household had poor screening uptake [ 15 ]. As a study from Ethiopia also suggests, improving women’s autonomy can result in the improved use of health services [ 31 ].…”

“…There is an increasing focus on exploring and addressing cancer-related stigma in India [ 13 , 14 ]. Additionally, household factors such as family set-ups and autonomy to make health-related choices and decisions can also influence health-seeking behaviours, especially among women [ 15 ].…”

Patterns and Predictors of Abortion Care-Seeking Practices in India: Evidence From a Nationally Representative Cross-Sectional Survey (2019-2021)

“…Comprehensive women empowerment: In this study, a woman was considered empowered if she said yes to all the following: Owned a mobile phone, had a bank/savings account, was at least educated up to high school, and could take decisions when it comes to money. In previous studies, factors such as a woman's ability to make decisions involving care of herself, employment status, making a major household purchase, visits to her family and relatives, owning a house/land alone or jointly with her husband, and using hygienic methods of protection during her menstrual period are also considered when focusing on comprehensive women empowerment [ 26 ]. However, owing to a lack of data points these factors were not considered in our analysis.…”

Menstrual and reproductive factors associated with risk of breast cancer among Indian women: a cross sectional study from National Family Health Survey, 2019-21

“…The screening coverage in the country is lower than the other countries [ 10 ]. The existing study mentioned that less than 10% of India women which ranges 25.3 to 48.4% ever undergo breast examination or participate in screening activities [ 11 ]. While, other Asian countries like china screening coverage was 57.6–82.3%, Thailand 55.8–63.6% and the Philippines 34.7–51.9% [ 12 ].…”