Psycho-oncology at the Crossroads: Cervical Cancer Awareness, Structural Barriers, and Gynecological Health Literacy among Women Attending in a Tertiary Care Psychiatry Hospital Setting

Abstract Background: Cervical cancer is the second-most common cancer among Indian women and has a high mortality rate. Its primary cause is persistent human papillomavirus infection, with additional risk factors such as early sexual activity, multiple partners, poor immunity, and smoking. Women with psychiatric illnesses are especially vulnerable due to impaired insight, reduced self-care, disinhibited behavior, disability, and substance use, all of which reduce their likelihood of undergoing cervical cancer screening. Aims and Objectives: This study aimed to identify factors associated with cervical cancer awareness among married women attending a psychiatry outpatient clinic. Materials and Method: A prospective cross-sectional study was conducted on 108 married women aged 30–65 years seeking mental health care at a tertiary psychiatric center. Participants were educated about cervical cancer, and their awareness and subsequent actions were recorded during follow-up. Results: Only 23 women (21%) were aware of cervical cancer, whereas 85 (79%) were unaware. Awareness varied by diagnosis: Women with psychosis NOS (F29) showed higher awareness (50%) compared to those with Schizophrenia (F20), with statistical significance ( P = 0.033). Despite forming the largest group ( n = 40), women with somatoform disorders (F45) showed low awareness (15%). Socioeconomic predictors – education ( P = 0.0005) and income ( P = 0.003) – were stronger determinants of awareness than clinical variables. Menopausal women were particularly vulnerable, with risks more likely to go unnoticed. A prevention paradox was observed: Even when aware, many patients failed to modify risk factors such as tobacco use or access screening. Conclusion: In conclusion, sociodemographic barriers, attitudinal resistance, systemic issues, and illness-related factors contribute to low awareness. Counseling about menopause, integrating screening reminders into mental health care, and improving screening accessibility may help address these preventable risk.