{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:32:35Z","timestamp":1790785955545,"version":"4.1.0"},"reference-count":51,"publisher":"Japan Epidemiological Association","issue":"3","funder":[{"name":"Japanese National Cancer Center Research and Development Fund","award":["2022-A-21"],"award-info":[{"award-number":["2022-A-21"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Epidemiology"],"published-print":{"date-parts":[[2025,3,5]]},"DOI":"10.2188\/jea.je20240065","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T18:12:17Z","timestamp":1725646337000},"page":"129-140","source":"Crossref","is-referenced-by-count":5,"title":["Regional Variations and Inequalities in Testing for Early Detection of Breast and Cervical Cancer: Evidence From a Nationally Representative Survey in India"],"prefix":"10.2188","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1018-8732","authenticated-orcid":false,"given":"Md. Mahfuzur","family":"Rahman","sequence":"first","affiliation":[{"name":"Graduate School of Public Health, St. Luke\u2019s International University"},{"name":"Division of Prevention, National Cancer Center Institute for Cancer Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1911-6807","authenticated-orcid":false,"given":"Md. Shafiur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Division of Prevention, National Cancer Center Institute for Cancer Control"},{"name":"School of Health Innovation, Kanagawa University of Human Services"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3568-0870","authenticated-orcid":false,"given":"Md. Rashedul","family":"Islam","sequence":"additional","affiliation":[{"name":"Division of Prevention, National Cancer Center Institute for Cancer Control"},{"name":"Hitotsubashi Institute for Advance Study, Hitotsubashi University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6556-0995","authenticated-orcid":false,"given":"Stuart","family":"Gilmour","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health, St. Luke\u2019s International University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7239-2611","authenticated-orcid":false,"given":"Rei","family":"Haruyama","sequence":"additional","affiliation":[{"name":"Bureau of International Health Cooperation, National Center for Global Health and Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Budukh","sequence":"additional","affiliation":[{"name":"Tata Memorial Centre, Homi Bhabha National Institute (HBNI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gauravi","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Preventive Oncology, Tata Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Mehrotra","sequence":"additional","affiliation":[{"name":"Centre for Health, Innovation and Policy Foundation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7311-1233","authenticated-orcid":false,"given":"Tomohiro","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Division of Prevention, National Cancer Center Institute for Cancer Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1276-2398","authenticated-orcid":false,"given":"Manami","family":"Inoue","sequence":"additional","affiliation":[{"name":"Division of Prevention, National Cancer Center Institute for Cancer Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3991-2739","authenticated-orcid":false,"given":"Sarah Krull","family":"Abe","sequence":"additional","affiliation":[{"name":"Division of Prevention, National Cancer Center Institute for Cancer Control"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"991","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1. Foreman KJ, Marquez N, Dolgert A, et\u00a0al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016\u201340 for 195 countries and territories. <i>Lancet<\/i>. 2018;392(10159):2052\u20132090.","DOI":"10.1016\/S0140-6736(18)31694-5"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008\u20132030): a population-based study. <i>Lancet Oncol<\/i>. 2012;13(8):790\u2013801.","DOI":"10.1016\/S1470-2045(12)70211-5"},{"key":"3","unstructured":"3. International Agency for Research on Cancer. World cancer report: cancer research for cancer prevention. Accessed March 1, 2023, https:\/\/publications.iarc.fr\/Non-Series-Publications\/World-Cancer-Reports\/World-Cancer-Report-Cancer-Research-For-Cancer-Prevention-2020."},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Sung H, Ferlay J, Siegel RL, et\u00a0al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. <i>CA Cancer J Clin<\/i>. 2021;71(3):209\u2013249.","DOI":"10.3322\/caac.21660"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Mandal R, Basu P. Cancer screening and early diagnosis in low and middle income countries: current situation and future perspectives [Krebsvorsorge und Fr\u00fcherkennung in L\u00e4ndern mit niedrigem und mittlerem Einkommen: Aktuelles Szenario und Zukunftsperspektiven]. <i>Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz<\/i>. Dec 2018;61(12):1505\u20131512.","DOI":"10.1007\/s00103-018-2833-9"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Lemp JM, De Neve JW, Bussmann H, et\u00a0al. Lifetime prevalence of cervical cancer screening in 55 low- and middle-income countries. <i>JAMA<\/i>. 2020;324(15):1532\u20131542.","DOI":"10.1001\/jama.2020.16244"},{"key":"7","unstructured":"7. Ferlay J, Ervik M, Lam F, et al. Global cancer observatory: cancer today. Lyon: International Agency for Research on Cancer; 2020. International Agency for Research on Cancer. Available from: https:\/\/gco.iarc.fr\/today, accessed [06 June 2023]. 2023."},{"key":"8","unstructured":"8. National Centre for Disease Informatics and Research. Report of National Cancer Registry Programme (2012\u20132016). 2020. Accessed August 12, 2023. https:\/\/www.ncdirindia.org\/All_Reports\/Report_2020\/resources\/NCRP_2020_2012_16.pdf."},{"key":"9","unstructured":"9. Budukh A, Thakur JS, Dikshit R, et al. Cancer Incidence and Mortality in Sangrur District, Punjab, India: 2017\u20132018 Tata Memorial Centre (TMC), Mumbai and Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India 2022. 2022. https:\/\/tmc.gov.in\/tmh\/pdf\/Reports\/Sangrur%20PBCR%20Report%202017-2018.pdf."},{"key":"10","unstructured":"10. Budukh A, Khanna D, Bagal S, et al. Cancer Incidence and Mortality in Varanasi District, Uttar Pradesh, India: 2018\u20132019 Tata Memorial Centre, Mumbai, India 2022. 2022. https:\/\/tmc.gov.in\/tmh\/pdf\/Reports\/Varanasi%20PBCR%20Detail%20report%20%202018-2019.pdf."},{"key":"11","unstructured":"11. Budukh A, Bagal S, Pandey N, et al. Cancer Incidence and Mortality in Muzaffarpur, Bihar State, India: 2018. Tata Memorial Centre (TMC), Mumbai, India 2023. 2023. https:\/\/tmc.gov.in\/tmh\/pdf\/Reports\/Muzaffarpur%20PBCR_2018.pdf."},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Pramesh CS, Badwe RA, Bhoo-Pathy N, et\u00a0al. Priorities for cancer research in low- and middle-income countries: a global perspective. <i>Nat Med<\/i>. 2022;28(4):649\u2013657.","DOI":"10.1038\/s41591-022-01738-x"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Birnbaum JK, Duggan C, Anderson BO, Etzioni R. Early detection and treatment strategies for breast cancer in low-income and upper middle-income countries: a modelling study. <i>Lancet Glob Health<\/i>. 2018;6(8):e885\u2013e893.","DOI":"10.1016\/S2214-109X(18)30257-2"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Kakushadze Z, Raghubanshi R, Yu W. Estimating cost savings from early cancer diagnosis. <i>Data<\/i>. 2017;2(3):30.","DOI":"10.3390\/data2030030"},{"key":"15","unstructured":"15. Ministry of Health and Family Welfare. Operational framework: Management of common cancers. 2016. Accessed June 12, 2023. https:\/\/main.mohfw.gov.in\/sites\/default\/files\/Operational%20Framework%20Management%20of%20Common%20Cancers_1.pdf."},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Krishnamoorthy Y, Ganesh K, Sakthivel M. Prevalence and determinants of breast and cervical cancer screening among women aged between 30 and 49 years in India: Secondary data analysis of National Family Health Survey\u20134. <i>Indian J Cancer<\/i>. 2022;59(1):54\u201364.","DOI":"10.4103\/ijc.IJC_576_19"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Singh S, Badaya S. Factors influencing uptake of cervical cancer screening among women in India: a hospital based pilot study. <i>J Community Med Health Educ<\/i>. 2012;2:157.","DOI":"10.4172\/2161-0711.1000157"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. Muthuramalingam MR, Muraleedharan VR. Patterns in the prevalence and wealth-based inequality of cervical cancer screening in India. <i>BMC Womens Health<\/i>. 2023;23(1):337.","DOI":"10.1186\/s12905-023-02504-y"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. Negi J, Nambiar D. Intersectional social-economic inequalities in breast cancer screening in India: analysis of the National Family Health Survey. <i>BMC Womens Health<\/i>. 2021;21(1):324.","DOI":"10.1186\/s12905-021-01464-5"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Nilima N, Mani K, Kaushik S, Rai SN. Cervical cancer screening and associated barriers among women in India: a generalized structural equation modeling approach. <i>Cancers (Basel)<\/i>. 2022;14(13):3076.","DOI":"10.3390\/cancers14133076"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Sen S, Khan PK, Wadasadawala T, Mohanty SK. Socio-economic and regional variation in breast and cervical cancer screening among Indian women of reproductive age: a study from National Family Health Survey, 2019\u201321. <i>BMC Cancer<\/i>. 2022;22(1):1279.","DOI":"10.1186\/s12885-022-10387-9"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Srivastava S, Kurian K, Garg PR, et\u00a0al. Prevalence and predictors of cervical cancer screening among reproductive age group women: evidence from cross-sectional study in Rohtak and Delhi. <i>Asian Pac J Cancer Prev<\/i>. 2022;23(8):2771\u20132777.","DOI":"10.31557\/APJCP.2022.23.8.2771"},{"key":"23","unstructured":"23. International Institute for Population Sciences, ICF. <i>National Family Health Survey (NFHS-5), 2019\u201321: India: Volume I<\/i>. 2021. National Family Health Survey, India."},{"key":"24","unstructured":"24. International Institute for Population Sciences and ICF. <i>National Family Health Survey (NFHS-5), 2019\u201321: India: Volume II<\/i>. 2021. Mumbai: International Institute for Population Sciences."},{"key":"25","unstructured":"25. TATA Memorial Center, National Cancer Grid of India. Consensus Evidence Based Resource Stratified Guidelines on Secondary Prevention of Cervical, Breast &amp; Oral Cancers. 2019. Accessed April 19, 2023. https:\/\/tmc.gov.in\/ncg\/docs\/PDF\/DraftGuidelines\/Preventive\/3_%20NCG_INDIA_Rev_Preventive%20Oncology_Primary_Care.pdf."},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Choi B, Um TR, Lee KS. Factors related to cancer screening behaviors. <i>Epidemiol Health<\/i>. 2018;40:e2018011.","DOI":"10.4178\/epih.e2018011"},{"key":"27","doi-asserted-by":"crossref","unstructured":"27. Schlotheuber A, Hosseinpoor AR. Summary measures of health inequality: a review of existing measures and their application. <i>Int J Environ Res Public Health<\/i>. 2022;19(6):3697.","DOI":"10.3390\/ijerph19063697"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28. Chen W, Qian L, Shi J, Franklin M. Comparing performance between log-binomial and robust Poisson regression models for estimating risk ratios under model misspecification. <i>BMC Med Res Methodol<\/i>. 2018;18(1):63.","DOI":"10.1186\/s12874-018-0519-5"},{"key":"29","doi-asserted-by":"crossref","unstructured":"29. Nene B, Jayant K, Arrossi S, et\u00a0al. Determinants of women\u2019s participation in cervical cancer screening trial, Maharashtra, India. <i>Bull World Health Organ<\/i>. 2007;85(4):264\u2013272.","DOI":"10.2471\/BLT.06.031195"},{"key":"30","doi-asserted-by":"crossref","unstructured":"30. Budukh A, Maheshwari A, Bagal S, et\u00a0al. Factors influencing women to participate in cervical cancer screening by providing menstrual pads: a population-based study from rural areas of Maharashtra state, India. <i>Indian J Cancer<\/i>. 2022;59(4):462\u2013468.","DOI":"10.4103\/ijc.IJC_910_19"},{"key":"31","unstructured":"31. World Health Organization, Directorate General of Health Services, National Institute of Preventive and Social Medicine. National STEPS survey for non-communicable diseases risk factors in Bangladesh 2018. 2018. Accessed April 29, 2023. https:\/\/cdn.who.int\/media\/docs\/default-source\/searo\/bangladesh\/publications\/2018-national-steps-survey-for-non-communicable-diseases-risk-factors-in-bangladesh.pdf?sfvrsn=9155c4b5_3&amp;download=true."},{"key":"32","unstructured":"32. Dhimal M, Bista B, Bhattarai S, et al. Report of Non communicable Disease Risk Factors: STEPS Survey Nepal 2019. 2020. Accessed July 10, 2023. https:\/\/www.who.int\/docs\/default-source\/nepal-documents\/ncds\/ncd-steps-survey-2019-compressed.pdf."},{"key":"33","doi-asserted-by":"crossref","unstructured":"33. Rahman MS, Rahman MM, Acharya K, et\u00a0al. Disparities and determinants of testing for early detection of cervical cancer among Nepalese women: evidence from a population-based survey. <i>Cancer Epidemiol Biomarkers Prev<\/i>. 2024;33(8):1046\u20131056.","DOI":"10.1158\/1055-9965.EPI-24-0037"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. Kastor A, Mohanty SK. Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: do Indian households face distress health financing? <i>PLoS One<\/i>. 2018;13(5):e0196106.","DOI":"10.1371\/journal.pone.0196106"},{"key":"35","unstructured":"35. Directorate General of Health Services. National programme for prevention and control of cancer diabetes, cardiovascular diseases &amp; stroke (NPCDCS), operational guidelines (revised: 2013-17). 2013. Accessed July 28, 2023. https:\/\/main.mohfw.gov.in\/sites\/default\/files\/Operational%20Guidelines%20of%20NPCDCS%20%28Revised%20-%202013-17%29_1.pdf."},{"key":"36","unstructured":"36. Tamilnadu Health System Project. Significant Interventions. Accessed July 11, 2023. https:\/\/tnhsp.org\/tnhsp\/significant-interventions.php."},{"key":"37","doi-asserted-by":"crossref","unstructured":"37. Patil P, Sarang B, Bhandarkar P, Ghoshal R, Roy N, Gadgil A. Does increase in women\u2019s empowerment and socio-economic conditions affect uptake of breast cancer screening? Findings from NFHS (5), India. <i>BMC Womens Health<\/i>. 2023;23(1):7.","DOI":"10.1186\/s12905-022-02147-5"},{"key":"38","doi-asserted-by":"crossref","unstructured":"38. Akinyemiju TF. Socio-economic and health access determinants of breast and cervical cancer screening in low-income countries: analysis of the World Health Survey. <i>PLoS One<\/i>. 2012;7(11):e48834.","DOI":"10.1371\/journal.pone.0048834"},{"key":"39","doi-asserted-by":"crossref","unstructured":"39. Srinath A, van Merode F, Rao SV, Pavlova M. Barriers to cervical cancer and breast cancer screening uptake in low- and middle-income countries: a systematic review. <i>Health Policy Plan<\/i>. 2023;38(4):509\u2013527.","DOI":"10.1093\/heapol\/czac104"},{"key":"40","doi-asserted-by":"crossref","unstructured":"40. Nyblade L, Stockton M, Travasso S, Krishnan S. A qualitative exploration of cervical and breast cancer stigma in Karnataka, India. <i>BMC Womens Health<\/i>. Aug 2 2017;17(1):58.","DOI":"10.1186\/s12905-017-0407-x"},{"key":"41","doi-asserted-by":"crossref","unstructured":"41. Grewal H, Sharma P, Dhillon G, Munjal RS, Verma RK, Kashyap R. Universal health care system in India: an in-depth examination of the Ayushman Bharat Initiative. <i>Cureus<\/i>. 2023;15(6):e40733.","DOI":"10.7759\/cureus.40733"},{"key":"42","doi-asserted-by":"crossref","unstructured":"42. Mahalakshmi S, Suresh S. Barriers to cancer screening uptake in women: a qualitative study from Tamil Nadu, India. <i>Asian Pac J Cancer Prev<\/i>. 2020;21(4):1081\u20131087.","DOI":"10.31557\/APJCP.2020.21.4.1081"},{"key":"43","doi-asserted-by":"crossref","unstructured":"43. Dsouza JP, 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. <i>Asian Pac J Cancer Prev<\/i>. 2020;21(8):2209\u20132215.","DOI":"10.31557\/APJCP.2020.21.8.2209"},{"key":"44","doi-asserted-by":"crossref","unstructured":"44. Acharya Pandey R, Karmacharya E. Cervical cancer screening behavior and associated factors among women of Ugrachandi Nala, Kavre, Nepal. <i>Eur J Med Res<\/i>. 2017;22(1):32.","DOI":"10.1186\/s40001-017-0274-9"},{"key":"45","doi-asserted-by":"crossref","unstructured":"45. Grosse Frie K, Ramadas K, Anju GA, et\u00a0al. Determinants of participation in a breast cancer screening trial in Trivandrum district, India. <i>Asian Pac J Cancer Prev<\/i>. 2013;14(12):7301\u20137307.","DOI":"10.7314\/APJCP.2013.14.12.7301"},{"key":"46","doi-asserted-by":"crossref","unstructured":"46. Changkun Z, Bishwajit G, Ji L, Tang S. Sociodemographic correlates of cervix, breast and oral cancer screening among Indian women. <i>PLoS One<\/i>. 2022;17(5):e0265881.","DOI":"10.1371\/journal.pone.0265881"},{"key":"47","doi-asserted-by":"crossref","unstructured":"47. Thomas VN, Saleem T, Abraham R. Barriers to effective uptake of cancer screening among Black and minority ethnic groups. <i>Int J Palliat Nurs<\/i>. 2005;11(11):562\u2013571.","DOI":"10.12968\/ijpn.2005.11.11.20096"},{"key":"48","doi-asserted-by":"crossref","unstructured":"48. Petersen Z, Jaca A, Ginindza TG, et\u00a0al. Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. <i>BMC Womens Health<\/i>. 2022;22(1):486.","DOI":"10.1186\/s12905-022-02043-y"},{"key":"49","doi-asserted-by":"crossref","unstructured":"49. Shin HY, Song SY, Jun JK, Kim KY, Kang P. Barriers and strategies for cervical cancer screening: what do female university students know and want? <i>PLoS One<\/i>. 2021;16(10):e0257529.","DOI":"10.1371\/journal.pone.0257529"},{"key":"50","doi-asserted-by":"crossref","unstructured":"50. Tripathi N, Kadam YR, Dhobale RV, Gore AD. Barriers for early detection of cancer amongst Indian rural women. <i>South Asian J Cancer<\/i>. 2014;3(02):122\u2013127.","DOI":"10.4103\/2278-330X.130449"},{"key":"51","doi-asserted-by":"crossref","unstructured":"51. Ong SK, Abe SK, Thilagaratnam S, et\u00a0al. Towards elimination of cervical cancer\u2013human papillomavirus (HPV) vaccination and cervical cancer screening in Asian National Cancer Centers Alliance (ANCCA) member countries. <i>Lancet Reg Health West Pac<\/i>. 2023;39:100860.","DOI":"10.1016\/j.lanwpc.2023.100860"}],"container-title":["Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/jea\/35\/3\/35_JE20240065\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T23:15:59Z","timestamp":1741389359000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/jea\/35\/3\/35_JE20240065\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":51,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2188\/jea.je20240065","relation":{},"ISSN":["0917-5040","1349-9092"],"issn-type":[{"value":"0917-5040","type":"print"},{"value":"1349-9092","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,5]]},"article-number":"JE20240065"}}