MOVING INDIA FROM REACTIVE TO PROACTIVE IN CANCER CARE

India faces a cancer burden that is growing steadily. According to estimates, over 1.4-1.5 million new cancer cases are recorded annually, with many diagnosed in advanced stages when prognosis is poorer. To reduce mortality and morbidity, a structural shift is needed from 'treating cancer after symptoms emerge', to 'detecting it early' or 'preventing it altogether'.

- DR RAKESH SHARMA

WHY EARLY DETECTION & PREVENTION MATTER

Expert evidence globally, and from India, shows that cancers of the breast, cervix, and oral cavity, which together account for roughly one-third of all cancer cases in India are often detectable at early stages where treatment is significantly more effective. A modelling study for cervical cancer in India found that screening every 5 years using visual inspection with acetic acid (VIA) is cost-effective (at ~US$ 829 per quality-adjusted life year [QALY] gained), and when combined with HPV vaccination, could reduce deaths by up to 70%.

THE CHALLENGES INDIA MUST OVERCOME

* Low awareness: Many people are unaware of early warning signs or screening guidelines.

* Inadequate infrastructure at the primary and district level to perform screening, followup, diagnostic confirmation, and timely treatment.

* Late presentation: As high as ~70% of cases in many parts of India are detected at advanced stages, making treatment costlier and less effective.