By Fellicita Pohsnem and cancer research team.
Indian Institute of Public Health-Shillong
November 7th is observed as the National cancer awareness day. The day was announced as a National cancer awareness day in India in 2014 by the health minister Dr Harsh Vardhan. Many might be wondering why the need of this day and what is its significance. The Nobel laureate, Madame Curie was born on this day in 1867 and has contributed to the fight against cancer through her work. Curie’s work to the development of radiotherapy for the treatment of cancer. The day is highlighted to emphasize the importance of awareness of cancer prevention and early detection.
According to the World Cancer Report, 2018, there were about 1.16 million new cancer cases, 784,800 cancer deaths in India’s population of 1.35 billion. Most of the cancer cases are diagnosed at an advanced stage that reduces chance of patient’s survival. The International Agency for Research on Cancer, the GLOBOCAN has predicted that the cancer burden in India will rise from nearly one million new cases in 2012 to over 1.5 million by 2035. The three most commonly occurring cancers in India are those of the breast, uterine cervix and oral cavity.
In 1975, National Cancer Control Program was initiated with a view to equip the facilities for cancer treatment. Later this program was modified in 1984-85 with an emphasis on the primary prevention and early detection. In an attempt to reduce the growing mortality rate of cancer in India, an initiative was taken by the Government of India through the implementation of the National Programme for prevention and control of cancer, diabetes and cardiovascular disease and stroke (NPCDCS) which is under the NHM to promote cancer awareness among the public through behavioural change with involvement of the community, civil society, community based organisation, opportunistic screening for early detection and referrals of suspected cases at the different health facilities in the community.
Cancer patterns in India are dominated by a high burden of tobacco-related and are associated with lower socioeconomic status. Tobacco (smoked and smokeless) use accounted for 3,17,928 deaths (approx) in 2018 as per the ICMR- NICPR (Indian council of medical research-National institute of cancer prevention and research) and this rate is expected to rise to 3500 person per day. Cancer is now the leading cause of catastrophic health spending and increasing expenditure before death in India. Out-of-pocket expenditure (OOPE) is three times higher for private inpatient cancer care in India. Most of the cancer costs are met through borrowing, sales of assets, and contributions from friends and relatives.
As per the ICMR report on cancer burden in the North Eastern states of the country, the incidence of all cancer is higher when compared to the rest of India. In Meghalaya, East Khasi Hills stand second highest cancer rate in India. Cancers that are common among males are oesophagus, lung and stomach while in females, cancer of breast, cervix oesophagus leads the list. The high incidence rate of cancers in the North East Region may be attributed to genetic factors, lifestyle and habits such as high intake of tobacco. Experts estimate that 2 or 3 in every 100 cancer cases are due to inherited faulty genes and 4 out of 10 cancers can be prevented by making simple lifestyle changes.
Lack of knowledge of the warning signs of cancer among the community is one of the contributing factors to the delays in care seeking. The Indian Institute of Public HealthShillong is currently undergoing a research study on understanding the factors influencing delay in cancer health seeking behaviour in Meghalaya. There is a seeming reluctance and even ‘stigma’ in the community that hampers talking about cancers, potentially contributing to delayed health seeking.
Therefore awareness plays an important role to maximize screening, early detection and early access to treatment to prevent cancer. If identified at the early stage, few cancers like breast, cervical, oral can be cured and treated with less cost. As seen in most of the community, on hearing the word ‘cancer’, it is not something that is talked or discussed openly as it affects the lives of many people however, it is very important to talk and raise awareness in order to prevent and fight cancer. The focus of public health policies for cancer is as the saying goes that ‘Prevention is better than cure’ therefore cancer can also be prevented through awareness of tobacco use as a risk following a healthy diet, being physically active and getting vaccinated for Human Papillomavirus (HPV).