A screening programme begins by finding out that 70% have never been screened

**Cervical cancer is the second leading cause of new cancer cases and of cancer
deaths among women in India** — an estimated **96,922 new cases and 60,078
deaths a year.**

It is also, unusually, preventable by screening. **Effective low-cost options
exist in India**, and the deaths are attributed to **limited access to
screening and treatment, diagnosis at a later stage, and low investment in
health care infrastructure.**

**In 2016 the Ministry of Health and Family Welfare recommended screening by
visual inspection with acetic acid every five years for women aged 30–65.**

This report establishes what that recommendation started from.

The baseline

Among women aged 30–49, 29.8% had ever been screened.

A four-and-a-half-fold difference between regions of the same country.

Screening was **higher among women with more education, greater household
wealth, who had ever been married, and urban residents** — and **also
associated with their partner's education**, which says something about how the
decision gets made.

Why a baseline is the right first output

A national screening recommendation without a starting measurement cannot be
evaluated. Coverage could rise from 29.8% to 40% and be reported either as
success or as failure depending on what anyone assumed it had been.

More usefully, the regional range says where to begin. A national average
of 29.8% suggests a national campaign; 10.0% against 45.2% says the
programme's problem is concentrated, and a uniform rollout would spend most of
its effort where coverage is already best.

The estimate is from the Fourth National Family Health Survey, 2015–2016 —
699,686 women aged 15–49, across all 29 states and seven union territories,
97.6% response rate, with the questionnaire **translated into 18 regional
languages and back-translated** for consistency. Screening was ascertained by a
single question: "Have you ever undergone a cervix examination?"

It serves as the baseline indicator under the **WHO Noncommunicable Diseases
Global Monitoring Framework** for **state-based programmatic rollout and
evaluation** — which is to say: this number exists so that the next one means
something.

Source: Centers for Disease Control and Prevention, MMWR.