• A recent study, Learning from the Indian National Family Health Survey (NFHS), analyzed trends in cancer screening in India, revealing significant declines.

• NFHS-4 (2015–16) reported that 22%, 10%, and 12% of women aged 15–49 had undergone screening for cervical, breast, and oral cancers respectively.

• However, NFHS-5 (2019–21) recorded a sharp decline, with only 1.2%, 0.6%, and 0.7% of women reporting the same. For men, oral cancer screening rates dropped from 9% in NFHS-4 to 0.2% in NFHS-5.

• The decline is attributed largely to differences in the framing of survey questions between NFHS-4 and NFHS-5. 

• In NFHS-4, questions used general terms like "Have you ever undergone a cervix/breast/oral cavity examination?" without explicitly mentioning "cancer" or "screening."

• This may have led respondents to include routine or pregnancy-related examinations.

• In contrast, NFHS-5 used more precise wording such as "Have you ever undergone a screening test for cervical cancer?" The clearer terminology likely reduced overestimation but exposed the actual low uptake of cancer-specific screenings.

• Other possible reasons include shifts in survey implementation, such as moving cancer-related questions from individual questionnaires in NFHS-4 to biomarker questionnaires in NFHS-5. This transition might have influenced participation and response rates.

• India's rising cancer burden, projected to increase from 1.39 million cases in 2020 to 1.57 million by 2025, underscores the need for accurate data collection and public health action.

• Recommendations include refining future surveys to better capture distinctions between routine and cancer-specific screenings and incorporating questions to assess cancer awareness.

• Anyone using NFHS figures to quote cancer screening percentages in India should acknowledge that the figures are not comparable between NFHS-4 and NFHS-5

• The NFHS data highlights critical gaps in cancer screening practices, offering valuable lessons for designing targeted interventions in India and other low- and middle-income countries to reduce preventable cancer cases and deaths.

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