Conference Abstracts - Summit on Cancer Health Disparities (SCHD26)
Vol. 6, Issue Supplement 1, 2026 · S1-3
A global perspective of colorectal cancer screening practices and cultural attitudes: Gujarat, India
Mili Parikh, MD,R. Todd Frederick, MD,Edward Holt, MD
Submission received: 2025-12-09 / Accepted: 2026-01-07 / Published: 2026-01-26
Background
There are no official colorectal cancer screening guidelines nationally in India or regionally in Gujarat. Introducing standardized screening guidelines can lead to the prevention and earlier detection of colorectal cancer [1]. Implementing screening programs can raise public awareness about colorectal cancer and its risk factors [2]. Disparities are wider among ethnic and racial minorities despite a higher disease burden [3,4]. By highlighting cultural attitudes of patients towards colorectal cancer screening, we can identify avenues through which to create lasting change. From 2011 to 2019, colorectal cancer increased from the ninth most common to the fifth most common cancer in India [5], suggesting a need for improved implementation of screening and further awareness of colorectal cancer [6, 7].
Methods
Anonymous surveys were distributed virtually or in person to patients visiting the outpatient department at the following sites in Gujarat: ISHA Hospital, Zydus Hospital, Sir Sayajirao General Hospital, HCG Cancer Center, Himalaya Hospital, Desai Hospital, Sumandeep Hospital, Everest Dignity Senior Living, and Kothi Hospital. Surveys consisted of 13 questions designed to elicit anonymous demographics, document understanding of colorectal cancer, and highlight reasons for lack of screening. Surveys were conducted either by the first author or by collaborating physicians at each of the aforementioned sites. Survey responses were then uploaded to a protected Excel spreadsheet.
Results
A total of 581 responses were collected, with 328 male and 253 female patients. In the study population, 83% followed a vegan or vegetarian diet, 62.7% held a college, masters, or doctoral degree, and 65.6% were not aware of colorectal cancer and associated risk factors. Most patients (62.5%) were unaware of colorectal cancer screening as a concept, and only 6.2% of patients had been recommended by a physician to obtain a colonoscopy for screening purposes. Most patients (80%) pay for medical care out of pocket; however, 81.4% of patients denied any challenges in accessing or affording medical care. When asked what would convince patients to undergo colorectal cancer screening, 60.6% stated a recommendation from their doctor would incentivize them, while 29.3% stated less expensive measures would be effective. Of note, 17.6% of patients expressed interest in non-invasive screening alternatives (e.g., stool test instead of colonoscopy).
Conclusion
This study demonstrates the cultural attitudes toward colorectal cancer screening in a subset of the Indian population. It reinforces the fact that there are no official guidelines nationally in India or regionally in Gujarat regarding colorectal cancer screening. Prior to this study, the authors hypothesized that the largest barrier to colorectal cancer screening would be purely financial, as most diagnostic and therapeutic care in the outpatient setting in India requires out-of-pocket payment [9,10]. However, it appears that lack of knowledge regarding colorectal cancer screening (despite a highly educated population), lack of recommendation from physicians, and low trust in the healthcare system also contribute strongly. Increased education regarding colorectal cancer and screening modalities is needed in India.
Next steps
Increased grassroots education regarding colorectal cancer screening is desperately needed in India. Patients would benefit from learning about colorectal cancer and screening options, and providers would benefit from reinforced education highlighting the importance of screening and preventative care. I will be returning to India in 2026 to kickstart an extensive educational campaign at multiple hospitals, medical schools, and community centers nationwide.
References
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