Barriers and Facilitators of Cancer Screening Uptake in Meghalaya and Mizoram States under the National Programme for Prevention and Control of NCDs in India: A Mixed-methods Study

Biswas, Sutapa; Paul, Bobby; Ghosh, Anushka; Mondal, Ranajit; Siddiqi, Maqsood

doi:10.31557/APJCP.2026.27.9.3465

Barriers and Facilitators of Cancer Screening Uptake in Meghalaya and Mizoram States under the National Programme for Prevention and Control of NCDs in India: A Mixed-methods Study

Document Type : Research Articles

Authors

¹ Cancer Foundation of India, Kolkata, India.

² All India Institute of Public Health, Kolkata, India.

³ Chittaranjan National Cancer Institute, Kolkata, India.

10.31557/APJCP.2026.27.9.3465

Abstract

Objective: Cancer is a leading cause of both morbidity and mortality in India. In response, the government launched a national screening programme under the National Programme for Prevention and Control of Non-communicable Diseases (NPCDCS/NP-NCD). Despite comprehensive guidelines, screening rates remain very low. We conducted a field study in Meghalaya and Mizoram between 2021 and 2023 to identify barriers and facilitators to cancer screening uptake, involving a diverse group of stakeholders. Methods: The mixed-methods study included 420 frontline health workers (FLHWs), 38 government officials, 75 key informants from non-governmental organisations, and 244 community members. We employed purposive and snowball sampling methods to recruit a diverse group of participants for qualitative data collection. For quantitative data collection, we used a stratified random sampling technique. Data collection comprised surveys, in-depth interviews and free-listing in both physical and virtual settings. Quantitative data from FLHWs were statistically analysed, while qualitative data from other stakeholders were reviewed and thematically coded using Anthropac version 4.98.1/X, with graphical visualisation in ATLAS.ti. Results: Stakeholders highlighted critical barriers to cancer screening uptake. At the individual level, obstacles include fears of diagnosis. At the community level, lack of cancer awareness and social stigma persist. Healthcare facilities face challenges like infrequent cancer screenings and resource shortages. At the policy level, insufficient financial support and ineffective communication strategies were key issues. Stakeholders recommended innovative awareness campaigns, information sharing through community events and gram sabhas, and engagement of community leaders and NGOs. They also emphasised upgrading infrastructure, enhancing staff training and adding screening facilities in villages. Conclusion: The study offers a detailed analysis of barriers and facilitators to cancer screening uptake, as highlighted by a diverse group of stakeholders. Findings suggest that complex, multi-layered challenges require innovative communication strategies and systemic improvements to enhance participation in cancer screening within the NPCDCS/NP-NCD initiatives in Meghalaya and Mizoram.

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