Context

According to a recent report from 13 states prepared by NITI Aayog (Niti Aayog’s alarm bells on cancer detection: C the signs), ‘huge gap’ in cancer screening at Ayushman centers is detected. 

• The states included were Andhra Pradesh, Bihar, Gujarat, Haryana, Jammu & Kashmir, Kerala, Madhya Pradesh, Maharashtra, Odisha, Rajasthan, Sikkim, Tripura, and Uttar Pradesh.

About Cancer

Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. 

• Mechanism: Cancer starts when a gene or several genes mutate and create cancerous cells. These cells create cancer clusters, or tumors. Cancerous cells may break away from tumors, using the lymphatic system or bloodstream to travel to other areas of the body.

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Need for Early Cancer Detection

• Increase the Surviving Possibility: It is well-known that spotting signs of cancer at an early stage significantly increases the possibilities of surviving the disease. 
• Rising Cases: Cancer has become a public health concern in India and has touched most families. There is growing evidence about the proven role of preventive strategies to minimize the risk of cancer and screening methods to detect cancer at an early stage for better survival.

Key Findings of the Report

• Existence of Huge Gaps: In the performance of these health and wellness centres (HWCs), a huge gap exists. 
  • Less than 10% of these centres had completed one round of screening for non-communicable diseases, including cancer.
  • Successive National Family Health Surveys have revealed that a very small percentage of people in the vulnerable age group (those over 30 years of age) get screened for malignancy. 
• Challenge of Investment & Awareness: India does not seem to have invested adequately in the next steps and also, there is low awareness and education of cancer, its prevention protocols and training to use the screening techniques. 

Initiatives taken in India for Early Cancer Detection

• The National Programme for the Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke: These programmes have given special emphasis to checking for cervical, oral and breast cancers.
  • They constitute a third of all cases of the disease in India before symptoms appear. 
• Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY): Under this initiative, 1,50,000 health and wellness centres (HWCs) turned into nodal points for cancer detection.
  • The introduction of screening facilities at these primary healthcare centres could have reduced accessibility-related problems to a great extent. 
• Establishment of a Training Hub: The Union Ministry of Health has designated the Noida-based National Institute for Cancer Prevention and Research as a training hub. 
  • The institution’s expertise must be summoned for screening malignancy. Experts agree that such instruction can be given online and professionals receiving such training can educate others.
• Involvement of Community-level Workers: In recent years, India has done well in piloting low-tech approaches to cancer screening that can be delivered at scale by community-level workers. AB-PMJAY makes use of these technologies. 
  • India involved ASHA workers in its project.

Way Forward

• Adequate Awareness: It is imperative that ASHA workers should be sensitised to risk factors, symptoms and the need for screening itself. 
• Improvement in Condition of Frontline Workers: There is a need to improve the working conditions of these low-paid and overburdened workers. 
• A Multi-Pronged Approach: Reducing India’s cancer burden will require efforts in several directions. There is a need to close gaps in cancer screening that are significant in view of the government’s focus on prevention and detection of cancer at an early stage.

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