Research Critique I
India is one of the largest countries in the world. With a population of 1.3 billion people, it is the second largest country in terms of population, although the seventh largest in terms of land. Approximately 48% of the citizens living in India are women. There is a significant number of women in the country, however women’s reproductive health seems to be an aspect of life that is not prioritized. Cervical cancer is the second most common cancer found in women throughout the entire world, and in India, is the most common cause of cancer-related death among women. (Narayana, Jyothi, Sunanda, Dasaratha, Pradeep, & Veerabhadrappa, 2017) According to Narayana et. al., one woman in India dies every eight minutes due to cervical cancer.
There is a significant time difference between the onset on cervical cancer and when Indian women begin treatment. There are women who do not believe it necessary to undergo screenings and are not seen until the cancer is too advanced in the system, developing into later stages, and their symptoms are too intense to ignore. Symptoms include “bleeding between periods, persistent back pain, pelvic pain, bleeding after intercourse, urinary urgency, unexplained weight loss, and severe swelling in one or both legs.” (Narayana, Jyothi, Sunanda, Dasaratha, Pradeep, & Veerabhadrappa, 2017, p.481) These symptoms begin early enough that, if checked, would greatly raise the chances and lengths of survival. With almost half of the country being composed of women, I am interested in researching the reasoning for the lack of urgency in preventing such a large percentage of the population from dying. Is there a reluctance to seek treatment because of lack of resources? Is there a sense of fear of diagnosis? Considering HPV can be a main cause of cervical cancer, is reluctance due to fear of stigmas or discrimination?
Survival of cervical cancer in the United States is rated to be one of the highest in the world. There are stark differences in survival between races in the United States, however. There are higher diagnosis rates within the Hispanic and Black ethnicities versus white, as well as a lower survival rate in black women versus white women. (Bernard, Watson, Saraiya, Harewood, Townsend, Stroup, Weir, & Allemani, 2017). This infers that there is a difference in the US within the women who are able to receive treatment, because of the distribution of women’s reproductive health resources. In the United States, women who live in areas of lower socio-economic status are going to have less access to preventative measures of HPV and treatment options if contracted. The same reasoning may be mirrored in India, as well. In the United States, because of the relationship that HPV has with areas of lower socioeconomic areas or status, the cultural stigma of HPV is very negative. Women will shy away from telling family, friends, and lovers of their diagnosis. The possibility of the same reasons may be seen in India as well.
The stigma for contracting HPV or having problems with one’s female reproductive system tends to cause women to be out-casted, embarrassment, and reluctance to screenings or treatment. The problem is the only way to potentially survive cervical cancer is to participate in frequent screenings, as well as undergoing a treatment process. I would be interested in comparing the number of women who are willing to undergo treatment for HPV and cervical cancer in more rural areas, versus those in urban areas. I would also like to take that a step further, and speak to women in both areas about their reluctance to treatment. Even if they were not diagnosed with HPV or cervical cancer, it would be something to think about: if they ever were diagnosed, would they seek treatment? Can they explicitly give an explanation as to why? Would these women be willing to explain what would happen if they were to go back to their family with news of an HPV diagnosis?
This topic is significant to me, as someone’s physical health is directly linked to their mental health. If someone is not willing to seek treatment of a deadly disease because of the stigmas and possibility of discrimination, they are going to be dealing with something very serious and personal, and there is the high chance they will be doing it alone. This can lead to forms of depression, anxiety, and ultimately, the possibility of suicide. This is important to remember, considering India is now the nation with the leading number of suicides in the world. This goes deeper than that, with there being an “unusually large proportion of youth—including young women—that complete suicide in the country.” (Ebenezer & Joge, 2016, p. 567) According to research conducted by Ebenezer and Joge, 86% of attempts were “isolated impulsive attempts following triggers,” with 71% of those being composed of “interpersonal disputes.” Another 45% of attempts were by people with a background of interpersonal conflict. Many of these cases can be composed of people who have been diagnosed with a life-threatening disease, and instead of seeking treatment, chose to end their life. So by being aware of this ongoing issue with suicide, and raising numbers of untreated women with cervical cancer and/or HPV, one has the ability to understand and work with women who are undergoing these painful events.
References
Benard, V. B., Watson, M., Saraiya, M., Harewood, R., Townsend, J. S., Stroup, A. M., & ... Allemani, C. (2017). Cervical cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer (0008543X), 1235119-5137. doi:10.1002/cncr.30906
Ebenezer, J. A., & Joge, V. (2016). Suicide in Rural Central India: Profile of Attempters of Deliberate Self Harm Presenting to Padhar Hospital in Madhya Pradesh. Indian Journal Of Psychological Medicine, 38(6), 567-570. doi:10.4103/0253-7176.194911
Narayana, G., Suchitra, M. J., Sunanda, G., Ramaiah, J. D., Kumar, B. P., & Veerabhadrappa, K. V. (2017). Knowledge, attitude, and practice toward cervical cancer among women attending Obstetrics and Gynecology Department: A cross-sectional, hospital-based survey in South India. Indian Journal Of Cancer, 54(2), 481-487. doi:10.4103/ijc.IJC_251_17
India is one of the largest countries in the world. With a population of 1.3 billion people, it is the second largest country in terms of population, although the seventh largest in terms of land. Approximately 48% of the citizens living in India are women. There is a significant number of women in the country, however women’s reproductive health seems to be an aspect of life that is not prioritized. Cervical cancer is the second most common cancer found in women throughout the entire world, and in India, is the most common cause of cancer-related death among women. (Narayana, Jyothi, Sunanda, Dasaratha, Pradeep, & Veerabhadrappa, 2017) According to Narayana et. al., one woman in India dies every eight minutes due to cervical cancer.
There is a significant time difference between the onset on cervical cancer and when Indian women begin treatment. There are women who do not believe it necessary to undergo screenings and are not seen until the cancer is too advanced in the system, developing into later stages, and their symptoms are too intense to ignore. Symptoms include “bleeding between periods, persistent back pain, pelvic pain, bleeding after intercourse, urinary urgency, unexplained weight loss, and severe swelling in one or both legs.” (Narayana, Jyothi, Sunanda, Dasaratha, Pradeep, & Veerabhadrappa, 2017, p.481) These symptoms begin early enough that, if checked, would greatly raise the chances and lengths of survival. With almost half of the country being composed of women, I am interested in researching the reasoning for the lack of urgency in preventing such a large percentage of the population from dying. Is there a reluctance to seek treatment because of lack of resources? Is there a sense of fear of diagnosis? Considering HPV can be a main cause of cervical cancer, is reluctance due to fear of stigmas or discrimination?
Survival of cervical cancer in the United States is rated to be one of the highest in the world. There are stark differences in survival between races in the United States, however. There are higher diagnosis rates within the Hispanic and Black ethnicities versus white, as well as a lower survival rate in black women versus white women. (Bernard, Watson, Saraiya, Harewood, Townsend, Stroup, Weir, & Allemani, 2017). This infers that there is a difference in the US within the women who are able to receive treatment, because of the distribution of women’s reproductive health resources. In the United States, women who live in areas of lower socio-economic status are going to have less access to preventative measures of HPV and treatment options if contracted. The same reasoning may be mirrored in India, as well. In the United States, because of the relationship that HPV has with areas of lower socioeconomic areas or status, the cultural stigma of HPV is very negative. Women will shy away from telling family, friends, and lovers of their diagnosis. The possibility of the same reasons may be seen in India as well.
The stigma for contracting HPV or having problems with one’s female reproductive system tends to cause women to be out-casted, embarrassment, and reluctance to screenings or treatment. The problem is the only way to potentially survive cervical cancer is to participate in frequent screenings, as well as undergoing a treatment process. I would be interested in comparing the number of women who are willing to undergo treatment for HPV and cervical cancer in more rural areas, versus those in urban areas. I would also like to take that a step further, and speak to women in both areas about their reluctance to treatment. Even if they were not diagnosed with HPV or cervical cancer, it would be something to think about: if they ever were diagnosed, would they seek treatment? Can they explicitly give an explanation as to why? Would these women be willing to explain what would happen if they were to go back to their family with news of an HPV diagnosis?
This topic is significant to me, as someone’s physical health is directly linked to their mental health. If someone is not willing to seek treatment of a deadly disease because of the stigmas and possibility of discrimination, they are going to be dealing with something very serious and personal, and there is the high chance they will be doing it alone. This can lead to forms of depression, anxiety, and ultimately, the possibility of suicide. This is important to remember, considering India is now the nation with the leading number of suicides in the world. This goes deeper than that, with there being an “unusually large proportion of youth—including young women—that complete suicide in the country.” (Ebenezer & Joge, 2016, p. 567) According to research conducted by Ebenezer and Joge, 86% of attempts were “isolated impulsive attempts following triggers,” with 71% of those being composed of “interpersonal disputes.” Another 45% of attempts were by people with a background of interpersonal conflict. Many of these cases can be composed of people who have been diagnosed with a life-threatening disease, and instead of seeking treatment, chose to end their life. So by being aware of this ongoing issue with suicide, and raising numbers of untreated women with cervical cancer and/or HPV, one has the ability to understand and work with women who are undergoing these painful events.
References
Benard, V. B., Watson, M., Saraiya, M., Harewood, R., Townsend, J. S., Stroup, A. M., & ... Allemani, C. (2017). Cervical cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer (0008543X), 1235119-5137. doi:10.1002/cncr.30906
Ebenezer, J. A., & Joge, V. (2016). Suicide in Rural Central India: Profile of Attempters of Deliberate Self Harm Presenting to Padhar Hospital in Madhya Pradesh. Indian Journal Of Psychological Medicine, 38(6), 567-570. doi:10.4103/0253-7176.194911
Narayana, G., Suchitra, M. J., Sunanda, G., Ramaiah, J. D., Kumar, B. P., & Veerabhadrappa, K. V. (2017). Knowledge, attitude, and practice toward cervical cancer among women attending Obstetrics and Gynecology Department: A cross-sectional, hospital-based survey in South India. Indian Journal Of Cancer, 54(2), 481-487. doi:10.4103/ijc.IJC_251_17