The Health Department, in partnership with the Regional Cancer Centre, is launching a major initiative to tackle the increasing incidence of cancer in the State by improving cancer screening, detecting cancer early, and by creating better awareness of the disease at the community-level.
The year-long campaign, “Kerala against Cancer,” being launched on February 4, is a special initiative of the State government, apart from the ongoing National Programme for the Control and Prevention of Cancers, Diabetes, Cardiovascular diseases and Stroke (NPCDCS), under which a host of cancer-care initiatives have been launched in five districts.
“This is a programme which will take cancer screening and detection to the sub-centres and primary health centres. We will have trained health workers and ASHAs to guide those picked up through screening to either the RCC or the medical college hospital where the treatment will be initiated and which could be followed up at the district hospital. The entire project proposal, including the training for doctors and nurses, has been put forth by the RCC and will be implemented by the Health Services,” a senior health official said.
The focus will be initially on three cancers — breast, cervix, and oral cavity — highly prevalent in the State and for which early detection and treatment offer good prognosis. These are also the cancers for which fairly good care can be offered even at district hospitals.
Doctors’ trainingIn the first phase, the scheme will be implemented in the capital district plus the five NPCDCS districts where decentralised cancer care is on, with a set of trained doctors and nurses — Idukki, Pathanamthitta, Alappuzha, Thrissur, and Kozhikode.
ASHAs and health workers will go on house visits and all women between 35-60 years, those with a history of cancer in the family as well as men with tobacco/alcohol habits will be brought in for medical camps to the sub-centres.
The RCC has already begun training doctors as well as nurses in the basics of cancer screening. Nurses and doctors are being trained to do visual examination of the mouth for leucoplakia, Pap smear for testing for cervical cancer, and physical examination plus fine needle aspiration cytology (FNAC) for detecting breast cancer.
“The huge and unwieldy number of samples which we will have to get diagnosed in laboratories is a major challenge. We do not have enough lab technicians. One way out will be to route some of the samples to medical college labs and to district hospitals which already have a tie-up with select accredited labs under the RSBY. It will not be easy, because we are expecting to screen about seven lakh people in the first phase,” a senior official told The Hindu .
A software has been developed for the screening programme, under which every person being screened for cancer will be given a unique patient ID, which will be retained if he/she has to go for treatment. This will also help the RCC build a registry of the actual number of persons screened/detected and evolve an accurate profile of the State’s cancer morbidity.
A fruitful exercise?However, the primary challenge of the programme will be to persuade people to undergo cancer screening and worse still, to ensure that those suspected of having cancer reach hospitals for treatment.
There are also questions whether hurrying with a mammoth community-level cancer screening programme across districts without a dedicated investment in manpower or laboratory infrastructure could be a fruitful exercise. Screening programmes which may involve repeat visits for diagnostic evaluation could become logistic nightmares as well as scare people into dropping off the radar.
