Barriers to help-seeking for cancer in India: A scoping review

Background and objectives Cancer is a leading cause of death in India, with delays in diagnosis and treatment contributing to poor outcomes. Although several studies document these delays, most focus on single cancer types or specific regions. This review aimed to synthesise evidence across cancers to identify barriers to help-seeking and their implications for cancer control in India. Methods A scoping review was conducted using Arksey and O'Malley and Levac frameworks, guided by the PRISMA-ScR checklist. The protocol was registered on the Open Science Framework. Systematic searches were carried out in PubMed, EMBASE, and Scopus for studies published in English between January 2010 and December 2024. Eligible studies included empirical research on barriers to help-seeking among individuals with cancer in India. Titles and abstracts were screened using Rayyan, followed by full-text review. Data were charted and synthesised thematically. Results Of 349 records screened, 30 studies met the inclusion criteria. Barriers were categorised as: financial and economic, lack of awareness/knowledge, cultural stigma and embarrassment, reliance on alternative medicine, systemic and health system inefficiencies, psychological fear and distrust, family and gender bias, and COVID-19-related disruptions. These factors collectively led to delays in presentation, diagnosis, and treatment of cancer in India. Interpretation and conclusions Delays in cancer care in India arise from intersecting socio-economic, cultural, systemic, and gendered barriers. Strengthening insurance coverage, patient navigation, awareness initiatives, gender-sensitive services, and long-term investments in rural infrastructure and psychosocial support are critical to improving timely cancer care.