Study uncovers new strategy to boost life-saving cervical cancer screenings

Cervical cancer is the fourth most common cancer among women globally, according to the World Health Organization. It accounted for 660,000 new cases and 350,000 deaths in 2022.

Screening, along with early detection and treatment, can greatly improve a patient's chances of survival. But in low- to middle-income countries, many women are not being screened, and they're disproportionately dying from the disease.

In new research from Texas McCombs, Anima Nivsarkar, a doctoral student in marketing, uncovers a powerful tool to boost screening: trust. When messages are delivered by trusted and credible sources such as doctors and peers, they increase the likelihood that women will seek potentially life-saving exams.

The study began when a primary health care provider in India asked Nivsarkar - with Vedha Ponnappan and Prakash Satyavageeswaran from the Indian Institute of Management Udaipur and Sundar Bharadwaj from the University of Georgia - for help encouraging women to get cervical cancer screenings.

In discussions with local nonprofits, they found powerful social barriers - taboos and misconceptions around reproductive health - even when women knew that screening was available.

"It's one of the cancers that is preventable, so then, what is it that is holding back women from actually getting the screening?" says Nivsarkar.

These interviews helped us uncover that it was primarily the social stigma, the sociocultural norms that existed in these areas, that were holding back women from getting screened and taking charge of their health."

Anima Nivsarkar, University of Texas at Austin

Doctors and hospitals typically rely on print materials, such as infographics, to educate the public. Nivsarkar's team explored a more personalized form of messaging: videos recorded by physicians and peers. They found that both types of message carriers helped raise screenings more than printed information alone.

Effects were strongest, the researchers found, when a communicator's message matched their role.

• Using peers to deliver messages of empowerment and taking ownership over one's health could increase screenings 36.5%, suggesting the potential to reach an additional 21 million women in India.
• When authority figures such as doctors or relatable sources such as peers explained the risks of not getting screened, women were willing to pay more for screening: enough that clinics could afford to screen 21% more women.

Although the research focused on a specific audience and issue, it may have applications in other health care contexts involving cultural barriers, Nivsarkar says. Similar approaches might work for other kinds of stigmatized reproductive health services or in communities where mental health screening encounters taboos.

The results challenge the strategy of depending on infographics or the mere provision of factual information, Nivsarkar says. "Given that peer-empowering messages led to the largest increase in adoption, we recommend public health campaigns shift toward leveraging peer influence with culturally attuned appeals."