Breast cancer is fast becoming a public health crisis in India, and society’s squeamishness over women’s bodies could make the situation even worse.

Over 46% of Indian women surveyed by Aegon Life Insurance said that taboos around discussing sexuality and menstruation make it difficult to promote an understanding of breast cancer. Aegon Life surveyed 550 men and women aged between 18 and 54 in major metros across the country.

“The Indian society has deemed several aspects of human physicality as taboo, which creates an obstacle to a free discourse on breast cancer and self-checking for lumps,” Aegon Life said in a statement. “Many respondents said that several cultural factors dissuade women, specifically, from discussing certain physical ailments with their family, which eventually might lead to a delay in accessing the required healthcare.”

That matters because breast cancer is the most common form of the disease afflicting women in India, and is likely to kill a staggering 76,000 women a year by 2020. Doctors say a lack of awareness about self-examination means that early detection and treatment are rare, and that’s contributing to a higher death toll.

More worryingly, the Aegon Life survey reveals that many Indians aren’t entirely sure what causes breast cancer, believing it to be the result of hormonal problems. Actually, it’s a combination of lifestyle-related factors, such as having children later in life and breastfeeding less, that are believed to increase the risk.

Moreover, only about 3% of the respondents said their friends and family knew about the disease and conducted self check-ups. But nearly a quarter had never discussed breast cancer with them.

Is there enough awareness amongst your friends and family about breast cancer? Respondents Yes 17.22% No 33.42% They have an in-depth understanding about the disease and the signs to look for 1.29% They know about the disease and conduct self check-ups 3.34% They have a superficial understanding of the disease 20.05% I have never discussed this with my friends and family 24.68%

To top it off, nearly 55% said they had no idea that October was breast cancer awareness month.