Govt. mulls PPP model to detect cancer centers

New Delhi, January 22, 2018: The government is mulling public-private partnership (PPP) model cancer detection centers with Tata Trust in states like Bihar, Jharkhand and Chhattisgarh in order to reach out to a larger population, said Mr Ashwini Kumar Choubey, Minister of State for Health & Family Welfare at an ASSOCHAM event held in New Delhi today.About 8.2 million people die due to cancer across the world every year, said Mr Ashwini Kumar Choubey while inaugurating an ASSOCHAM conference on National Congress on Cervical Cancer: A Race to Overcome the Killer Disease.

Dr SumitaGhosh, Dy. Commissioner (Maternal Health), Ministry of Health & FamilyWelfare, GoI addressing the conference said that the government has identifiednearly 125 centres for mass screening for oral, breast and cervical cancer.

 ProfRavi Mehrotra, Director, National Institute of Cancer Prevention and Researchsaid India has no ambassadors for cervical cancer and our local languages don’teven have a name for it.

 ProfMehrotra further said that India contributes to nearly one-fourth of the globalburden of cervical cancer, with it being the 2nd most commonfemale cancer here in terms of both incidence and mortality. Therefore,researchers emphasized the need for population-based interventions in India toreduce the overall burden of cervical cancer globally. Despite the lack oflarge scale screening programmes, there was a decline noted in the cervicalcancer in urban India. However, the decline was much slower in rural areas.

 Thejoint study on ‘Cervical Cancer’ prepared by ASSOCHAM-NICPR reveals, Indiaalone has for one fourth of the global burden of cervical cancers1, 2. Itaccounts for 17% of all cancer deaths among women aged between 30 and 69 years.It is estimated that cervical cancer will occur in approximately 1 in 53 Indianwomen during their lifetime compared with 1 in 100 women in more developedregions of the world.

 Thereare 29 hospital-based cancer registries and 29 population-based cancerregistries (PBCRs) under NCRP. Their data shows that cervical cancercontributes to approximately 6–29% of all cancer in females at differentlocations within the country. Cervical cancer is the leading site in 6 registryareas viz., Barshi Rural, Barshi Expanded, Mizoram, Tripura, Nagaland andPasighat PBCRs, adds the study.

 Theage-adjusted incidence rate of cancer cervix was found to vary widely amongregistries, highest being 23.07/100,000 in Mizoram State, followed by22.54/100,000 in Pasighat (Arunachal Pradesh) and the lowest being 4.91/100,000in Dibrugarh district of Assam. The older PBCRs such as Bengaluru, Bhopal,Chennai, Delhi, and Barshi Rural (Maharashtra) had an age-adjusted incidencerate between 13 and 16/100,000.

 Morethan 85% of patients of cervical cancer were from age group 40 years and above.The maximum numbers of cases were reported in 50–59 years of age groupamounting to 27.37% of all cervical carcinoma cases, noted the study.

 Indeveloped countries, conventional cytology screening programs have shown amarked decline in the incidence of cervical cancer. It has worked for India aswell, but to a lesser extent. In India, although many institutes are involvedin cancer screening, but there have been very few coordinated initiatives frompublic health authorities for prevention and control of cervical cancer atnational level.

Cervicalcancer is the fourth most common cancer in women and the seventh most commoncancer overall. In 2012, worldwide, there were estimated to have been around528,000 new cases. Around 85% of the global burden occurs in the less developedregions, where cervical cancer accounts for almost 12% of all cancers infemales. High-risk regions, with estimated 2012 age-standardized incidencerates of more than 30 cases per 100,000 females, include eastern Africa (42.7cases), Melanesia (33.3 cases), southern Africa (31.5 cases), and centralAfrica (30.6 cases). Incidence rates are lowest in Australia/New Zealand (5.5cases) and western Asia (4.4 cases), highlighted the study.

 Cervicalcancer remains the most common cancer in women in eastern and central Africa.In contrast to developed countries, cervical cancer is a public health problemin developing countries like India.

 Thereason for these variations seems to be the lack of preventive and earlydetection and treatment programmes in low- to middle income countries. Withoutthese interventions, cervical cancer is usually only detected when it isalready at an advanced stage when it's too late for effective treatment, andhence mortality becomes high. Over the last 30 years, cervical cancer incidenceand mortality rates have fallen in countries where social and economic statushas improved. This seems primarily due to the implementation of secondaryprevention measures, like screening, early diagnosis and treatment forpre-cancer and early cancer.

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