Importance Of Cancer Screening Tests
Let me start with the well-established fact that ‘almost all cancers are completely treatable if detected in the early stage and if diagnosed late, most are very difficult and even impossible to treat. Several cancer hospitals and NGOs have been offering basic check-ups virtually free of cost to find out whether a person is potentially susceptible to get cancer and needs to undergo certain specific tests, but a vast majority of the people do not avail of these – perhaps due to the fear that if he/she is diagnosed with the disease, how is he going to come up with the cost of treatment, what will happen to his job, what will the family do etc. etc.
These are ground realities and yet one has to understand that once the disease advances:
(a) treatment cost will probably become 10X and
(b) there is every possibility of great pain and even fatality and
(c) most hospitals offer treatment at concessional rates and also free in the case of 10 per cent of low income patients.
Hospitals and NGOs regularly organise ‘cancer detection camps’ in middle and low- income colonies, a fair amount of publicity is done in the area through posters or door-to-door information, even RWAs are roped in and yet, response of the people is much less than the optimum numbers that can be screened in a typical 8/12-hour day. A well-equipped bus – offering pathological tests, X-ray, Mammography etc. – arrives early on the day and is usually parked in a community centre or outside a public park or any other space offered by the locality; volunteers, doctors and technicians set up a couple of tables to help people fill up forms with basic information, equipment in the bus is hooked up to a power connection and the team is ready to start.
Typically, the crew can scan about 100 persons (including 50 woman) in a day. Test findings are transmitted in real time to a designated lab; later in the day blood samples are also sent and usually in an hour or two the person can go back. Final reports of those who need further examination are sent to them in a day or two and, if required, they are guided to the hospital for treatment at highly subsidised rates or even free of cost. Yet, I have almost never seen a camp getting 100 people!
Myths about cancer being the ‘Wrath of God’ and the ‘illogical stigma’ attached to the disease still persist despite all the propaganda through newspapers, TV and short documentaries regularly screened in cinemas before the movies. Totally beyond logic is the situation when even well-off people refuse to undergo the tests, either at these camps or in privacy with their own doctors.
All this continues to rapidly increase the number of cancer patients in the country. Incidentally, once a person is diagnosed with cancer, even after a successful treatment and no reoccurrence for as long as15/16 years no insurance company – public or private – accepts the person for medical cover. Even in case of an old existing policy, the insured cannot increase the amount covered!
Most heart rending is to see little kids afflicted with cancer. For those from poor families and rural areas, the suffering is much greater as they have to travel long distances for reaching a good hospital, are unable to pay for the treatment and one of the parents has to stay back to earn living expenses for the family. As per a recent report (TOI, 20 February) survivors, helped by the NGO, CanKids KidsCan have appealed to the government to consider starting a ‘Comprehensive Childhood Cancer Policy’ so that these kids can grow up with an umbrella in case the disease reoccurs or they are faced with any other health issues.
Recently in a short video, that seems to have gone viral, someone asks a group of youngsters “which screen has changed your life?” There are many answers – mobile phone, TV, Cinema, Laptop – depending on what is most important to each till one girl narrates how her young and fit doctor friend had succumbed to cancer and her closing words, “if only she had taken the simple cancer screening test, she would’ve been here with us” shakes up everyone in the group. She closes the conversation with, “for me this screen has changed my life!” It has been estimated that in 70 per cent cases in India, cancer is detected too late. All these lives could’ve been saved had there been regular screening.
Just to mention one type of cancer – cervical – (January ‘24 News Letter of the Rajiv Gandhi Cancer Institute) which is “one of the most preventable” – claimed the lives of 341,000 women globally in 2020 alone. Most of these deaths occurred in low and lower-middle- income countries due to inadequate access to cervical cancer prevention, screening and treatment”. The World Health Organization (WHO) had launched a global strategy, in November 2020, to accelerate elimination of this scourge by implementing the triple intervention targets of:
(a) HPV vaccination of 90 per cent girls up to the age of 15
(b) screening of 70 per cent women with the HPV test by the age of 35 and again by 45 and (c) adequate care and treatment to 90 per cent of women identified with cervical precancer. In India this is the second most prevalent cancer in women (14.7 per lakh women) and needs urgent steps to check its frightening spread. Equally important are other major cancers like Breast, Lung, Oral, Stomach, Colorectal, Liver, Oesophageal and Prostate. We need a concerted drive to increase the capacity and geographical spread of screening facilities and a strong drive to sensitise the people about consequences of not going for regular basic screening tests.
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