Translating evidence into practice in low resource settings: cervical cancer screening tests are only part of the solution in rural India

Asian Pac J Cancer Prev. 2012;13(8):4169-72. doi: 10.7314/apjcp.2012.13.8.4169.


Background: The majority of women in rural India have poor or no access to cervical cancer screening services, although one-quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting.

Methods: This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness.

Results: The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness.

Conclusions: The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Early Detection of Cancer*
  • Evidence-Based Practice*
  • Female
  • Health Behavior
  • Health Resources*
  • Humans
  • India / epidemiology
  • Middle Aged
  • Pilot Projects
  • Practice Patterns, Physicians'*
  • Prognosis
  • Rural Population
  • Translational Research, Biomedical*
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / prevention & control