Cancer screening uptake and tobacco–alcohol use among women in Uttarakhand - A district-wise analysis from the 5th National Family Health Survey (NFHS-5)

Sep 22, 2026

Cancer screening for cervical, breast, and oral cancer lowers morbidity and mortality, yet uptake in India remains limited, especially in hilly regions such as Uttarakhand. Using National Family Health Survey (NFHS-5) district-level data, the study evaluates screening patterns among women aged 30–49 years and examines district-level tobacco and alcohol use and female literacy as contextual determinants. Findings show low and uneven coverage across districts and highlight the need for stronger outreach, primary care integration, mobile services, and community mobilisation.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages6

Reading Time15 min

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Background and objectives

Methods

Results

Interpretations and conclusions

Indian J Med Res 163, May 2026, pp 625-629 DOI: 10.25259/IJMR_2658_2025 Research Brief Cancer screening uptake and tobacco–alcohol use among women in Uttarakhand: A district-wise analysis from the 5th National Family Health Survey (NFHS-5) Santosh Kumar, 1 Pallvi Kaul,1 Kanika Kapur, 1 Deepti Choudhary,2 Yadav Alka Rajkumar, 1 Astha Arora1 and Pankaj Kumar Garg 1 Departments of 1Surgical Oncology, and 2Obstetrics and Gynaecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Shri Guru Ram Rai University, Dehradun, Uttarakhand, India Received September 26, 2025; Accepted November 28, 2025; Ahead of print May 9, 2026; Published May 16, 2026 Background and objectives: Screening for cervical, breast, and oral cancer reduces morbidity and mortality, yet uptake in India remains low, particularly in hilly States such as Uttarakhand. This study assesses district-level screening patterns among women in Uttarakhand using National Family Health Survey (NFHS-5) data. Methods: District-wise self-reported screening among women aged 30–49 years was analysed and categorised as absent (0.0%), moderate (0.1–0.4%), or high (≥0.5%). District-level tobacco and alcohol use among women aged ≥15 years and literacy were also reviewed. Results: Screening uptake ranged from absent to moderate across districts. Haridwar (0.90%) and Champawat (0.57%) reported the highest coverage, while several hilly and urban districts, including Tehri Garhwal, Rudraprayag, Pauri Garhwal, Dehradun, and Nainital, reported no uptake. Tobacco use was highest in Bageshwar (7.7%) and Pauri Garhwal (6.4%), whereas alcohol consumption remained low (0.1–0.7%) . A moderate negative correlation was observed between literacy and screening– Haridwar showed the uptake despite lower literacy, while more literate districts like Chamoli and Pithoragarh reported lower participation. Interpretations and conclusions: Cancer screening uptake among women in Uttarakhand remains low and uneven. Literacy did not ensure greater participation, underscoring the need for stronger outreach, primary care integration, mobile screening in hilly areas, and community mobilisation. Keywords Breast cancer; Cancer screening; Cervical cancer; Oral cancer; Tobacco Cancer remains a major public health challenge in India, where late-stage diagnosis contributes to poor outcomes.1-3 Screening for cervical, breast, and oral cancers is a cost-effective strategy, yet uptake remains low, particularly in rural and hilly states like Uttarakhand, due to geographic, sociocultural, and infrastructural barriers.4 The National Family Health Survey (NFHS-5, 2019–21) provides district-level data on screening coverage and related factors, including tobacco and alcohol use,5 which increase cancer risk, as well as literacy, which reflects health awareness. Examining these variables together helps identify local disparities and inform targeted policy action.6 Uttarakhand’s diverse terrain, from densely populated plains to remote high-altitude regions, creates substantial variation in healthcare access and utilisation. NHFS-5 highlights this imbalance, with urban districts having better-equipped facilities and specialist services, while several hilly districts rely primarily on primary health centres and community health workers. These geographic and system-level constraints, combined with variations in women’s literacy and behavioural risk factors, contribute to uneven cancer screening uptake across the State. Although the National Programme for Prevention and Control of Non-Communicable Diseases How to cite this article: Kumar S, Kaul P, Kapur K, Choudhary D, Rajkumar YA, AroraA, et al. Cancer screening uptake and tobacco–alcohol use among women in Uttarakhand: A district-wise analysis from the 5th National Family Health Survey (NFHS-5). Indian J Med Res. 2026;163:625-9. doi: 10.25259/IJMR_2658_2025 © 2026 Indian Journal of Medical Research, published by Scientific Scholar for Director

FAQs

Which cancers and age group were included in the screening uptake analysis?

The study analyzed screening uptake for cervical, breast, and oral cancers among women aged 30–49 years using NFHS-5 data.

How did the study categorize screening uptake levels across districts?

District-level screening uptake was grouped as absent (0.0%), moderate (0.1–0.4%), or high (≥0.5%) based on women’s self-reports.

What relationship did the study observe between literacy and cancer screening uptake?

The study found a moderate negative correlation between literacy and screening uptake, with some less-literate districts still reporting higher uptake.

Sep 22, 2026

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