{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:03Z","timestamp":1789609083661,"version":"build-2803163510"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Tamil Nadu Health System Reform Program, Government of Tamil Nadu"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-026-45005-2","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T17:01:08Z","timestamp":1774544468000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cervical cancer screening coverage and care cascade in Tamil Nadu, India, based on a community-based cross-sectional survey"],"prefix":"10.1038","volume":"16","author":[{"given":"Manikandanesan","family":"Sakthivel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Ramalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Chadwick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mosoniro","family":"Kriina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manjula Devi","family":"Neelavannan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusuya","family":"Govindan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devendhiran","family":"R","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vettrichelvan","family":"Venkatasamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Devasagayam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surya","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon","family":"Thirumurugan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swathy","family":"Madhusoodanan L","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Jilumudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshavardhini","family":"Vasu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidhya","family":"Viswanathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnaraj","family":"K","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerard Maria","family":"Selvam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selvavinayagam","family":"T S","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vineeth","family":"S","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Thamburaj","family":"A","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senthil Kumar","family":"Palaniandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"45005_CR1","unstructured":"Cervical cancer [Internet]. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/cervical-cancer (2025)."},{"key":"45005_CR2","unstructured":"Cancer Today [Internet]. https:\/\/gco.iarc.who.int\/today\/ (2025)."},{"key":"45005_CR3","unstructured":"Report of National Cancer Registry Programme. 2020 [Internet]. https:\/\/ncdirindia.org\/All_Reports\/Report_2020\/default.aspx (2025)."},{"key":"45005_CR4","unstructured":"National Programme for Prevention and Control of Non Communicable Diseases (NP-NCD). Guidelines | Ministry of Health and Family Welfare | GOI [Internet]. https:\/\/www.mohfw.gov.in\/?q=Major-Programmes\/non-communicable-diseases-injury-trauma\/Non-Communicable-Disease-II\/National-Programme-for-Prevention-and-Control-of-Cancer-Diabetes-Cardiovascular-diseases-and-Stroke-NPCDCS (2025)."},{"key":"45005_CR5","unstructured":"National, S. & Territory, U. and District Fact Sheets 2019-21 National Family Health Survey NFHS5 (English) [Internet]. https:\/\/dhsprogram.com\/publications\/publication-OF43-Other-Fact-Sheets.cfm (2025)."},{"key":"45005_CR6","unstructured":"TNHSP [Internet]. https:\/\/tnhsp.org\/pages\/view\/Cervical_Cancer (2025)."},{"issue":"1","key":"45005_CR7","doi-asserted-by":"publisher","first-page":"39","DOI":"10.4103\/ijc.IJC_548_19","volume":"59","author":"V Viswanathan","year":"2022","unstructured":"Viswanathan, V., Ganeshkumar, P., Selvam, J. M. & Selvavinayagam, T. S. Referral mechanism and beneficiary adherence in cervical cancer screening program in Tiruchirappalli district, Tamil Nadu state, India, 2012\u20132015. Indian J. Cancer. 59 (1), 39 (2022).","journal-title":"Indian J. Cancer"},{"key":"45005_CR8","doi-asserted-by":"publisher","unstructured":"Ramalingam, A. et al. A cross-sectional study on hypertension and diabetes care cascade and prevalence of noncommunicable diseases (NCD) risk factors in Tamil Nadu: rationale and methods [Internet]. medRxiv 2025, 2025.03.24.25324492. https:\/\/doi.org\/10.1101\/2025.03.24.25324492v1 (2025).","DOI":"10.1101\/2025.03.24.25324492v1"},{"key":"45005_CR9","unstructured":"STEPwise approach to NCD risk factor surveillance (STEPS). [Internet]. https:\/\/www.who.int\/teams\/noncommunicable-diseases\/surveillance\/systems-tools\/steps (2025)."},{"key":"45005_CR10","unstructured":"DAGitty v3. 1 [Internet]. https:\/\/www.dagitty.net\/dags.html (2025)."},{"key":"45005_CR11","unstructured":"StataCorp. Stata Statistical Software: Release 17. College Station (StataCorp LLC, 2021)."},{"key":"45005_CR12","unstructured":"R Core Team. _R: A Language and Environment for Statistical Computing_ [Internet]. Vienna, Austria: R Foundation for Statistical Computing. https:\/\/www.r-project.org\/ (2025)."},{"key":"45005_CR13","unstructured":"Tableau Desktop [Internet]. https:\/\/www.tableau.com\/support\/releases (2025)."},{"key":"45005_CR14","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s12885-025-13446-z","volume":"25","author":"P Garg","year":"2025","unstructured":"Garg, P. et al. Urban-rural disparities in cervical cancer screening among Indian women between 30\u201349 years: a geospatial and decomposition analysis using a nationally representative survey. BMC Cancer. 25, 67 (2025).","journal-title":"BMC Cancer"},{"issue":"8","key":"45005_CR15","doi-asserted-by":"publisher","first-page":"e1115","DOI":"10.1016\/S2214-109X(22)00241-8","volume":"10","author":"L Bruni","year":"2022","unstructured":"Bruni, L. et al. Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: a review and synthetic analysis. Lancet Glob. Health 10 (8), e1115\u2013e1127 (2022).","journal-title":"Lancet Glob. Health"},{"key":"45005_CR16","unstructured":"Lifetime Prevalence of Cervical Cancer Screening in 55. Low- and Middle-Income Countries | Cervical Cancer | JAMA | JAMA Network [Internet]. https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2771901 (2025)."},{"key":"45005_CR17","doi-asserted-by":"publisher","first-page":"101427","DOI":"10.1016\/j.pmedr.2021.101427","volume":"23","author":"KA Robb","year":"2021","unstructured":"Robb, K. A. The integrated screening action model (I-SAM): a theory-based approach to inform intervention development. Prev. Med. Rep. 23, 101427 (2021).","journal-title":"Prev. Med. Rep."},{"issue":"8","key":"45005_CR18","doi-asserted-by":"publisher","first-page":"2209","DOI":"10.31557\/APJCP.2020.21.8.2209","volume":"21","author":"J Preema Dsouza","year":"2020","unstructured":"Preema Dsouza, J., Van den Broucke, S., Pattanshetty, S. & Dhoore, W. Exploring the barriers to cervical cancer screening through the lens of implementers and beneficiaries of the national screening program: a multi-contextual study. Asian Pac. J. Cancer Prev. APJCP. 21 (8), 2209\u20132215 (2020).","journal-title":"Asian Pac. J. Cancer Prev. APJCP"},{"key":"45005_CR19","doi-asserted-by":"crossref","unstructured":"Dsouza, J. P. & Broucke, S. V. den. DOST: a consolidated health behavior model that maps factors influencing cancer screening uptake. Arch. Public Health 83, 70 (2025).","DOI":"10.1186\/s13690-025-01517-3"},{"key":"45005_CR20","unstructured":"National Health Systems Resource Centre. Healthcare Utilization & Expenditure in India: State Fact Sheets [Internet]. New Delhi, India: National Health Systems Resource Centre, Ministry of Health and Family Welfare, Government of India. https:\/\/nhsrcindia.org\/sites\/default\/files\/2021-06\/State%20Fact%20Sheets_Health%20care%20Utilization%20and%20Expenditure%20in%20India.pdf (2014)."},{"key":"45005_CR21","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.canep.2017.06.008","volume":"49","author":"P Adsul","year":"2017","unstructured":"Adsul, P., Manjunath, N., Srinivas, V., Arun, A. & Madhivanan, P. Implementing community-based cervical cancer screening programs using visual inspection with acetic acid in India: a systematic review. Cancer Epidemiol. 49, 161\u2013174 (2017).","journal-title":"Cancer Epidemiol."},{"issue":"5","key":"45005_CR22","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.31557\/APJCP.2021.22.5.1393","volume":"22","author":"V Srinivas","year":"2021","unstructured":"Srinivas, V. et al. Community-based mobile cervical cancer screening program in rural India: successes and challenges for implementation. Asian Pac. J. Cancer Prev. APJCP. 22 (5), 1393\u20131400 (2021).","journal-title":"Asian Pac. J. Cancer Prev. APJCP"},{"key":"45005_CR23","doi-asserted-by":"publisher","first-page":"100182","DOI":"10.1016\/j.glmedi.2025.100182","volume":"5","author":"OJ Ezeigwe","year":"2025","unstructured":"Ezeigwe, O. J. et al. Impact of patient-physician communication on cervical cancer screening among women aged 25\u201365. J. Med. Surg. Public. Health. 5, 100182 (2025).","journal-title":"J. Med. Surg. Public. Health"},{"issue":"6","key":"45005_CR24","doi-asserted-by":"publisher","first-page":"1648","DOI":"10.1177\/2374373520924993","volume":"7","author":"TB Kindratt","year":"2020","unstructured":"Kindratt, T. B., Atem, F., Dallo, F. J., Allicock, M. & Balasubramanian, B. A. The influence of patient\u2013provider communication on cancer screening. J. Patient Exp. 7 (6), 1648\u20131657 (2020).","journal-title":"J. Patient Exp."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-45005-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-45005-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-45005-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T23:25:37Z","timestamp":1778714737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-45005-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["45005"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-45005-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]},"assertion":[{"value":"10 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"DJ, HV, VS, ATA, and SKP are employees of, or affiliated with, the Tamil Nadu Health System Reform Program, which provided funding support for this study. The funders had no role in study design, data collection, analysis, or writing of the manuscript. All other authors (MS, AR, JC, MK, MDN, AG, DR, VV, ED, SJ, ST, SM, RN, MR, VV, KK, STS, JMS) declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"We obtained ethical approval from the Institute Human Ethics Committee (IHEC) of ICMR-National Institute of Epidemiology with the ID NIE\/IHEC\/202304-02. The study involved human participants, and we obtained written informed consent before the interview. All study procedures were conducted in accordance with the Declaration of Helsinki and the ICMR National Ethical Guidelines for Biomedical and Health Research (2017).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"15131"}}