Sir,
In India, there are approximately 948,900 new cancer cases and 633,500 deaths annually.[1] This large-scale morbidity and mortality of cancer can easily be minimized with
well-planned cancer education, organized screening, and early detection programs.
However, there has been no organized cancer screening program across the country in
India, and it remains mainly opportunistic, with the consequence that a majority of
the cancers are diagnosed at advanced stages of the disease. The standard methods
and technologies utilized for screening cancers in developed countries (e.g., cytology
for cervix and mammography for breast cancer screening) are not directly applicable
to developing countries like India, due to resource constraints and absence of trained
workforce. Hence, simple, socially and culturally acceptable, and cost-effective technologies
are required for organized cancer screening in the Indian scenario. Several such screening
tests for the early detection of common cancers and methods of implementing the same
at the community level have been tested in various parts of India.[2]
[3]
[4]
[5]
[6]
We conducted one such organized cancer screening camp in a rural settings to create
awareness of common cancers, detecting precancers of the cervix and oral cavity, and
early cancers of the breast, cervix, and oral cavity, through screening with the use
of simple, low-cost technology, i.e., naked eye oral visual inspection (OVI), clinical
breast examination (CBE), Visual inspection with acetic acid(VIA) of the cervix by
trained primary health-care workers, facilitating confirmation of diagnosis among
the screen positives, and treatment and follow-up of the diagnosed cases. These simple
screening methods are well recommended by the World Health Organization in low-resource
settings and have shown promising results.[7]
[8]
[9]
The screening camp was organized in a rural block of Haryana by the Department of
Community Medicine, PGIMER, Chandigarh in collaboration with local district hospital.
The camp had a total attendees of 90 participants (40 males and 50 females) above
30 years of age. A health education program on various risk factors of common cancers
was initially imparted to the participants. All participants underwent OVI for oral
cavity cancer, and all women underwent CBE for breast cancer screening. However, only
26 (52.0%) consented to undergo VIA for cervical cancer screening. Out of the 90 participants
undergoing OVI, one male participant was found to have leukoplakia, a premalignant
lesion and was counseled to quit smoking and habit of tobacco chewing and was referred
to the district hospital for further management. Out of the 50 women which undergone
CBE, two were found to have suspected breast lumps which were later confirmed as fibroadenomas.
Out of the 26 women undergone VIA, one was found positive which was later confirmed
as low-grade squamous intraepithelial lesion and was instituted on treatment.
The simple, low-cost technologies used for screening in this camp have been studied
in several trials in low-income countries.[2]
[3]
[4]
[5]
[6]
[10] The organized screening camp demonstrates an example of cancer screening program
in low-resource settings with considerably good success. Acceptability of the program
was also excellent, and a good number of suspected precancer cases were detected in
totally asymptomatic patients.
