Breast and cervical cancers are among the most preventable yet under-screened cancers in India. Informal women caregivers who accompany cancer patients through diagnosis, treatment, and follow-up maintain prolonged contact with oncology services and may be particularly receptive to prevention messages. However, caregiving responsibilities, socio-cultural norms, and health-system constraints may limit their engagement with cancer screening. Evidence integrating caregivers’ lived experiences with oncology healthcare professionals’ perspectives on missed and emerging screening opportunities remains limited in low- and middle-income country settings.

To explore barriers, facilitators, and system-level opportunities for breast and cervical cancer screening among informal women caregivers of cancer patients, incorporating perspectives from caregivers and oncology healthcare professionals in a tertiary cancer care setting in India.

A qualitative study was conducted at a tertiary cancer care centre in southern India between January and July 2023. In-depth interviews were conducted with 23 informal women caregivers of adult cancer patients, purposively recruited until data saturation, alongside four focus group discussions with 25 oncology healthcare professionals across medical, surgical, radiation, paediatric, and palliative oncology departments. Data were collected using semi-structured guides, audio-recorded with consent, transcribed verbatim, translated where required, and analysed inductively using Braun and Clarke’s thematic analysis, using an inductive approach with MAXQDA software. Data reported using the Standards for Reporting Qualitative Research (SRQR) checklist.

Caregivers reported variable awareness of breast and cervical cancer screening and commonly linked screening to symptoms rather than prevention. Despite close exposure to cancer care, many perceived themselves as healthy or protected by faith, expressed fear of painful procedures and a positive diagnosis, and described stigma and modesty concerns, particularly for cervical cancer screening. Screening was often deprioritised due to caregiving responsibilities, patient care as a priority, competing household/work demands, travel costs, and family-influenced decision-making. Healthcare professionals similarly described missed opportunities for opportunistic screening, noting that screening is not routinely raised in oncology consultations and is often deferred when caregivers are anxious or preoccupied; recommendations were more likely for those with a family history of cancer. Providers highlighted system barriers, including high clinical workload, limited consultation time, lack of dedicated preventive clinics, repeated registration steps, and delays in tests and reports that reduce the feasibility of same-day screening. Suggested solutions included clinician-led counselling, waiting-area education (videos/kiosks), peer support groups, streamlined workflows (walk-in services, direct report communication, reduced waiting), community outreach via ASHAs, HPV vaccination counselling, and institutional policies to embed caregiver screening into routine oncology care.

Although caregiving responsibilities and socio-cultural barriers frequently delay preventive care, sustained engagement with oncology services creates a critical window for opportunistic cancer screening among informal women caregivers. Integrating caregiver-focused counselling, streamlined screening pathways, HPV vaccination awareness, and dedicated preventive oncology services within tertiary cancer centres could support early detection and equitable cancer prevention. Embedding caregiver screening within institutional standard operating procedures and routine oncology workflows, rather than relying on individual provider initiative, may help normalise preventive care and, by ensuring consistent implementation, further strengthen health-system capacity for cancer prevention in LMICs.