Cancer Screening: PMO sets 3-month deadline for framework


MoS for AYUSH Shripad Naik recently said yoga can cure major diseases like cancer and the government could come out with scientific evidence within a year.

At a health sector review meeting chaired by Modi on March 14, the ministries of health and family welfare and AYUSH were asked to come up with a framework for a nationwide programme to screen cancer, diabetes and heart diseases by June this year.

Officials said promoting wellness and preventing diabetes and cardiovascular diseases through lifestyle changes and yoga is a key element of the programme, and preparation of quality yoga teachers one of its targets.

MoS for AYUSH Shripad Naik recently said yoga can cure major diseases like cancer and the government could come out with scientific evidence within a year.

At the meeting, the PMO also directed that 3,000 Jan Ausadhi stores must be set up in one month, kala azar and filariasis must be eliminated by 2017, a proposal for reforms in the Medical Council of India must be ready in two months, model concession agreements for PPP in the health sector must be created in six months, and the National Health Protection Scheme must be finalised in six months.

Pre-cancerous lesions in case of mouth and cervix and growths in case of breast can be detected early enough to ensure the malaise does not become a full-blown case of cancer.

The history of cervical cancer in the US shows what screening can achieve. In the 1960s and 1970s, the US saw an estimated 200,000 new cases of cervical cancer every year — roughly the same as India’s current numbers. That was also the time PAP smear emerged as an effective tool for screening. The US government took stringent measures, making it mandatory for all women of reproductive age who came to the hospital regardless of the nature of their diagnosis to undergo screening before being discharged. If a patient was not screened, the hospital to which she had been admitted was liable to pay a fine. Today, the number of new cases annually in the US is down to 10,000.

While the PAP smear is an expensive proposition requiring trained personnel, an inexpensive home-grown screening procedure for cervical cancer using vinegar, which was presented at the prestigious American Society of Clinical Oncology’s 2013 meeting, has not been utilised to its full potential in India, experts say. Doctors also say breast self-examination has not been popularised enough, even though it can help detect the disease in fairly early stages.

While India does have a programme on paper for screening of non-communicable diseases, cancer screening has been a virtual non-starter despite successive health reports presenting a grim picture of India’s cancer burden. According to figures compiled by the Central Bureau of Health Intelligence (CBHI), in 2012 the total number of cancer cases reported in India were 10,57,204. In 2013 that figure was 10,86,783, in 2014 it was 11,17,269, and in 2015 it stood at 11,48,692. According to projections by CBHI, which analysed cancer time trends, five years later the total number of cases in men will touch 6,22,203, while in women the figure will stand at 6,98,725.

India’s National Cancer Control Programme was initiated in 1975-76. In 2010, it was integrated with the national programmes for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 100 districts, where screening was to be done for some forms of cancer. Five years on, the Ministry of Health does not know how many people have been screened for cancer. Dearth of trained personnel, officials say, is the main reason for the screening programme’s failure.

“Cancer screening is one of the priority sectors identified in the review meeting. The PMO wants close coordination with the Ministry of AYUSH, especially on the prevention front, which is why the emphasis on yoga. That is primarily for the prevention of diabetes and cardiovascular diseases,” a ministry source said.

In the PMO meeting, the Health Ministry was also asked to move swiftly to bring in private players to ramp up health infrastructure and improve quality. “Create model concession agreements for PPP in health (across primary, secondary and tertiary). Set up a central body with an aim to promote innovative ideas for PPP in health,” read the minutes of the meeting.