Importance of Cancer Screening

Cancer screening plays a critical role in early detection and treatment of the ailment. The report of National Cancer Registry Programme (NCRP)-2020 has listed breast, cervix, and cervix uteri among the leading anatomical sites of women in the north-eastern States. The fifth round of the National Family Health Survey (NFHS-5), 2019-20 reveals that the region has much to do in early detection of cancer among adult women. The NFHS-5 phase-I data show that the screening for cancer in these anatomical sites among women in the region is quite low. In Assam, only 0.2 per cent of women in the age group of 30 to 49 years have ever gone for screening test of cervical cancer, 0.2 per cent have undergone breast examination for cancer while 0.2 per cent women in the age group have undergone oral cavity examination for oral cancer in the State. When it comes to the rural areas in Assam, only 0.1 per cent of women have ever gone for the screening test of cervical cancer. Nagaland and Meghalaya also recorded less than one per cent of women in this age group undergoing these screenings for cancer.

In Manipur, little over two per cent have undergone cervical cancer screenings while Mizoram has demonstrated an encouraging picture of 6.9 per cent undergoing screening test for cervical cancer and 2.7 per cent undergoing breast examination for cancer. However, only 0.9 per cent of women in the particular age group in Mizoram have undergone oral cavity examination for cancer. The gap between the alarming rise in cancer incidence in the region and cancer detection needs to be bridged and demands focused attention of the Central and the State governments in the region as well as other stakeholders. The awareness drive on cancer needs to be followed up with screening camps for targeted groups. Cancers in breast and cervix in women and oral and lungs in men account for 50 per cent of all cancer deaths in India. According to World Health Organisation (WHO), breast cancer accounts for over two million cases and 6.27 lakh deaths globally; and in India it is the most common cancer in women and accounts for 14 per cent of all cancers in women in the country. However if detected early, it can be treated successfully and save lives. Various studies suggest that occurrence rate of cervical cancer in women in India is almost double the rate in developed countries. These two types on cancer in women is the most common cancers globally and is rising fast across the globe. Data from the NFHS-5 will help the policy makers identify the gaps and draw up focussed and result-oriented action programmes. In the north-eastern States, roping in the panchayats, elected village councils and traditional village governance bodies into the cancer-screening-and-detection programmes can contribute to achieving the objectives of the National Cancer Control Programme.

The NFHS-5 data also reveals an alarming incidence of tobacco use among women aged 15 years and above in the region. In Mizoram, it is as high as 61.1 % followed by Manipur with 43.1 %. It is 28.2 % in Meghalaya, 22.1 % in Assam and 13.7% in Nagaland. The percentage is higher in rural areas as compared to urban areas in these States. In rural Mizoram, about 68.5 % women in this age group consume tobacco. The NCRP-2020 report states that higher proportion of women in the region had cancers associated with tobacco-use during the period from 2012-2016. "Breast cancer (estimated to be 2,38,908 cases in 2025) is expected to be the most common site of cancer in 2025 followed by cancer of the lung (1,11,328) and the mouth (90,060). Tobacco- related cancers are estimated to constitute 27% of all cancers in India," adds the report. More efforts are required to make the campaign against tobacco use in the region fruitful to prevent cancer. The 'Operational Framework: Management of Common Cancers' published by the Ministry of Health and Family Welfare states that "the costs of care for cancer treatment are high, and studies show that almost three quarters of cancer expenditure in India is paid out of pocket, despite the many welfare schemes for cancer treatment from both State and Central governments". The framework identifies cancers of breast, uterine cervix, and oral cavity as public health priority; and states that each of these three cancers is amenable to early detection and treatment, reducing the burden of cancer related mortality and morbidity. These three commonly occurring cancers accounts for 34 per cent of all cancers in the country. The framework has also laid down the most important task for the Central and the State governments that cancer-screening programmes require the assurance of high-quality treatment at affordable costs, regular follow up and accessible follow-up management as and when required. It will require strengthening of the existing Healthcare systems as well.