CHENNAI: At a time when the State government has rolled out a free HPV vaccination drive for girls aged 9-14 across the State to prevent cervical cancer, a new study has flagged a critical gap in the other pillar of prevention, screening, with only one in 10 eligible women ever tested and many dropping out before diagnosis.
The study, conducted in 2024 by researchers from the ICMR-National Institute of Epidemiology, Chennai, along with state health authorities, and published in Scientific Reports (2026), found that just 10% of women aged 30-69 years in Tamil Nadu had undergone cervical cancer screening at least once in their lifetime.
Drawing on a state-wide survey of 4,184 women across all districts, the study offers one of the most comprehensive community-level assessments of screening coverage and the care pathway in Tamil Nadu. While Tamil Nadu performs better than the national average of about 2%, it remains far short of the World Health Organization’s target of 70% coverage.
“The low coverage, combined with significant losses along the care cascade, underscores the need for strengthening both awareness and follow-up systems,” the authors noted.
The study maps what happens after screening, and where the system falters. Of the 423 women who reported being screened, 26% tested positive. But, only 57% of those were referred for a colposcopy, the next step in confirming diagnosis.
While most women who were referred did undergo the procedure, the initial referral gap emerged as the single largest bottleneck. “Referral of screen-positive women for colposcopy was the major bottleneck in the cascade,” the study observed, pointing to gaps in providing communication and weak linkage between primary and higher centres.
While Tamil Nadu performs better than the national average of about 2%, it remains far short of the World Health Organization’s target of 70% coverage
Public health experts say this significantly reduces the impact of screening programmes in TN. “Screening without assured follow-up defeats the purpose of early detection,” a senior official in the Health and Family Welfare department told DT Next.
The study also highlights a persistent awareness deficit. Among the 3,761 women who had never been screened, nearly 79% said they did not feel the need as they had no symptoms, while others cited lack of knowledge, time constraints, or access barriers. Screening uptake was higher among women aged 45-59, those with higher education, and those with conditions such as diabetes, a trend researchers attribute to greater interaction with the healthcare system.
Another key finding is the significant role of the private sector. Nearly 60% of screenings were conducted in private facilities, especially in urban areas, raising concerns about gaps in data capture and quality standardisation. “Integrating private sector data into public health monitoring systems is essential for accurate estimation of coverage,” the study noted.
District-level variations were also observed, with southern districts such as Thoothukudi, Tirunelveli and Tenkasi districts showing clusters of low screening coverage, suggesting uneven programme implementation.
The authors call for targeted behaviour change campaigns, particularly among younger and less-educated women, alongside strengthening referral systems and improving patient-provider communication. “Improving follow-up will require better coordination between screening and diagnostic services and reducing structural barriers such as travel and cost,” the study said.
Tamil Nadu has long been a pioneer in cervical cancer screening, having piloted programmes even before they were integrated into the national non-communicable diseases framework. And yet, the findings indicate that policy intent has not fully translated into population-level outcomes.